Description

The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

Responsibilities

Location:

work at home – must be licensed in the state of Kentucky

The Utilization Management Behavioral Health Professional 2 completes telephonic and paper reviews to obtain sufficient clinical information. The Utilization Management Behavioral Health Professional 2 uses clinical knowledge and independent critical thinking skills to apply the appropriate criteria to make a medical necessity determination.

• Complete telephonic and/or paper reviews with behavioral health facilities and behavioral health providers
• Reviews discharge plans
• Coordinates with Care Coordination and Case Management
• Prepares cases for clinical rounds with Medical Directors

Required Qualifications

• Degree in Nursing or a Master's degree in a Behavioral Health related field such as Social Work, Counseling, and/or Psychology, from an accredited university.
• Must be licensed in the state of Kentucky
• Such licenses are: Licensed Masters Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Psychologist (PhD), Registered Nurse (RN) or Licensed Marriage & Family Therapist (LMFT) or other professional licenses
• Minimum of three (3) years of post-degree clinical experience in direct patient care 
• Three (3) years or more of Behavioral Health experience
• Proficiency with Microsoft Office products
• Experience working with computers

Desired Qualifications

• Minimum of two (2) years of utilization management experience
• Experience with utilization review process
• Knowledge of community health and social service agencies and additional community resources in the state of KY
• Bilingual (English/Spanish); speaking, reading, writing, interpreting and explaining documents in Spanish

Additional Information

Company is an organization with careers that change lives – including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you’re ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Company has the right opportunity for you.

Scheduled Weekly Hours

40