Healthcare Consultant III

Coordinate and communicate with healthcare providers, internal teams, and external stakeholders to facilitate timely, appropriate care and authorization decisions. Skilled in evaluating clinical needs, reviewing records, and making sound decisions that balance quality, cost, and member-centered care.

Title: Healthcare Consultant III
Contract Length: 6 months
Location: Phoenix, Client 85006

**This is a remote position but does require a BH licenses, those have to be active in Arizona. We likely will not get candidates out of state with an Client BH license. They can live anywhere in Client doesn't have to be close to the office.**

Mercy Care is a not-for-profit Medicaid managed care organization serving Arizona since 1985. Mercy Care is administered by Client, a *** company, providing access to the resources of a national organization while maintaining strong local community engagement.

Primary Duties & Responsibilities:
• Review clinical information and apply medical necessity criteria, clinical guidelines, policies, and professional judgment to render coverage determinations and discharge planning decisions.
• Coordinate and communicate with healthcare providers, internal teams, and external stakeholders to facilitate timely, appropriate care and authorization decisions.
• Conduct concurrent reviews to monitor ongoing inpatient or outpatient treatment and support continuity of care.

Top 3 Skills
1. Behavioral Health Utilization Management
Ability to review clinical information, apply medical necessity guidelines, and make UM decisions (initial, concurrent, and discharge planning).
Includes strong discharge planning skills to support safe, appropriate transitions of care.

2. Clinical Assessment & Critical Thinking
Skilled in evaluating clinical needs, reviewing records, and making sound decisions that balance quality, cost, and member-centered care.
Must have a strong understanding of community behavioral health resources to support referrals and continuity of care.

3. Communication & Coordination
Strong communication skills with providers and internal teams, plus accurate documentation and strong organizational skills.
Ability to coordinate effectively across multiple stakeholders to support timely care and utilization decisions.

Work Environment & Schedule
•Primarily sedentary, desk-based role involving extended periods of sitting, talking, and focused review work.
• Standard schedule: Monday–Friday, 8:00 AM–5:00 PM Arizona time.
• Occasional holiday or weekend coverage required through rotation.

Education:

• Master’s degree required for behavioral health clinicians (LCSW, LPC, LMFT).
• Associate’s degree required for RN applicants.