Behavioral Health Utilization Manager

🔥 18 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $28 - $47 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Banner Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1999

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Banner Health is a leading healthcare system committed to making healthcare easier through comprehensive patient services and resources. They provide a safe place for care with services ranging from emergency and urgent care, imaging, and surgery centers to maternity and hospice care. Banner Health also offers telehealth options to ensure access to healthcare, regardless of location. They support athletes through Banner Orthopedics & Sports Medicine and have been recognized for exceptional patient care. With advanced digital tools, they aim to manage healthcare seamlessly for their patients.

📋 Description

• Review prior authorization requests for outpatient behavioral health services • Ensure medical necessity and alignment with clinical guidelines and health plan requirements • Collaborate with providers and interdisciplinary teams to support timely care decisions • Manage individual members across the health care continuum • Review and authorize behavioral health and substance abuse services in inpatient, residential, and outpatient settings • Monitor care to ensure treatment is appropriate and effective • Assess, develop, implement, monitor, and document member care plans and resource utilization • Facilitate options and services to meet members’ health care needs • Provide telephonic or electronic document review • Engage internal and external resources for appropriate care planning and discharge planning • Monitor for quality-of-care concerns • Staff regularly with medical directors • Provide education and recommend alternative care plans when treatment does not meet medical necessity criteria • Conduct prior authorization, concurrent, retrospective, and appeal reviews • Lead process improvement activities for patient populations • Evaluate medical necessity and appropriateness of care • Establish collaborative relationships with physicians, payers, and interdisciplinary health care teams • Collect and communicate pertinent information for utilization and regulatory requirements • Develop and manage interdisciplinary patient discharge plans • Educate internal health care team members on case management and managed care concepts

🎯 Requirements

• Requires master’s degree in social work, counseling or related field or independent or associate licensure • Licensure in at least one of the following categories as required by state law: social work, professional counseling or marriage and family • Appropriate licenses include: LCSW, LMSW, LPC, LAC, or Licensed Psychologist • Three years of clinical experience in counseling, care management, case management, or care coordination in inpatient or outpatient levels of care • Working knowledge of care management, case management, hospital and community resources • Critical thinking, problem-solving, effective communication, and time management skills • Ability to work effectively independently and in an interdisciplinary team format • Arizona residency required for compliance

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume