Utilization Review Case Manager - Remote

Overview

The Utilization Review Case Manager at Discovery Behavioral Health plays a crucial role in ensuring clients receive the maximum benefits from their insurance through effective communication and coordination with various stakeholders.

In Short

• Determine client medical necessity for insurance claims.
• Build cases for medical necessity for potential clients.
• Conduct pre-intake assessments for clients.
• Work with treatment teams to determine best care levels.
• Ensure accurate clinical documentation.
• File appeals for denied cases.
• Maintain organized and timely documentation.
• Communicate effectively with supervisors and staff.
• Demonstrate teamwork in a professional manner.
• Full-time position with flexible scheduling.

Requirements

• Master’s Degree preferred.
• Licensed LMFT, LCSW, LVN, or RN preferred.
• Experience in utilization review for substance use facilities.
• Strong knowledge of ASAM dimensions.
• Knowledge of DSM-V Codes.
• Familiarity with SUD, IOP, and Mental Health programs.
• Flexibility to meet critical deadlines.

Benefits

• 401(k) plan.
• Healthcare benefits.
• Vacation and sick days.
• Employee referral program.
• Employee discounts.
• Continuing education programs.
• Weekly training opportunities.
• Advancement opportunities.