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Behavioral Health Clinician
Integrated Resources, Inc
Watertown, MA
Contractor
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Job Title: Behavioral Health Clinician
Location: Remote
Duration: 03+ Months
Responsibilities:
Requirements:
Location: Remote
Duration: 03+ Months
Responsibilities:
- Conduct clinical pre-certification, concurrent and discharge reviews for behavioral health treatment requests.
- Evaluate clinical information to screen for medical necessity of behavioral health services and ensure members receive the most appropriate treatment based on their clinical presentation and needs.
- Consult with internal managers and physician advisors when it appears requests for services do not meet medical necessity criteria and propose alternative plans of treatment.
- Primary responsibility for outpatient and diversionary levels of care.
- Primary responsibility for CBHI (Children’s Behavioral Health Initiative) levels of care.
- Coordinate discharge plans to ensure members step down from acute care to an appropriate setting, and coordinate plans for additional treatment as needed.
- Consult with providers to assist members with transportation, employment, and daily living needs as they relate to individualized behavioral health treatment plans.
- Provide information to providers and members regarding behavioral health benefits and treatment resources. Provide telephonic triage and crisis intervention to callers. Interact with others in a professional, respectful manner that facilitates the treatment process.
- Identify through proactive concurrent reviews high-risk/high-cost complex members for internal case management and make appropriate referrals. Collaborate closely with Integrated Care Management and Medical Management departments to ensure behavioral, medical, and social care management interventions are integrated.
- Work collaboratively with other departments as appropriate.
- Adhere to all department and regulatory standards and ensure all workflow processes are completed within required timeframes.
Requirements:
- Minimum of two years of experience in clinical settings providing direct client care.
- Experience with managed care and/or Medicaid a plus.
- Minimum of 2 years post-master’s direct clinical experience; 3-5 years preferred.
- Active unrestricted Massachusetts licensure to practice independently as behavioral health clinician (LICSW, LMHC, LMFT, RN, PhD, PsyD).
- Master’s degree in behavioral health related discipline (social work, counseling psychology or related field, nursing).
Recommended Skills
Social Work
Case Management
Managed Care
Nursing
Medicaid
Crisis Intervention
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