Behavioral Health Care Coord - Roosevelt County

Job ID: DLP-1027353 Description:
Position Work from Home
(Roosevelt County)
This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members, reviewing medical records, reviewing cases which involve contract interpretation of behavioral health diagnoses, and utilizing knowledge of medical necessity criteria for all levels of behavioral health care from outpatient office visits to acute inpatient. Travel will be required to other locations outside the office or within assigned areas, as needed. In conjunction with other clinical resources, this position assists in the assessment, planning, facilitating, coordinating, monitoring, evaluating, and advocating for options and services required to meet an individual s and family s comprehensive health needs; promote quality, cost effective outcomes; serving as liaison to providers, physicians, and members including supporting the CareLink NM Health Homes.
Registered Nurse (RN) with current license or Masters-level Behavioral Health Professional with current license to practice at the independent practice level. Current clinical license in state of operations and in good standings.
3 years clinical experience in psychiatric setting or own behavioral health practice.
Verbal and written communication skills.
Analytical and decision making skills.
PC and database experience.
Willingness and ability to travel to assigned locations.
Care coordination experience.
Experience working with Non for Profit Organizations.
Experience working in an Insurance Company environment.
Justice Department experience
Willing to visit prisons and detention centers.
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Requirements: Expertise Behavioral Health, Government Programs, Nursing Job Type Full-Time Regular Location NM - Portales

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