Description
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members on the telephone, reviewing medical records, reviewing cases which involves 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 in-patient to out-patient office visits.JOB REQUIREMENTS:
- 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.
- REMOTE WORK
PREFERRED JOB REQUIREMENTS:
- Utilization review experience.
*CA
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HCSC Employment Statement:
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
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