Fidelis Care: Utilization Management Specialist – Behavioral Health
Fidelis Care
This is a Full-time position in Town Of Cambria, NY posted July 30, 2021.
Ensure all members are receiving the right care, in the right place, at the right time through Utilization Review and Discharge Planning work.
Work with hospital staff, community agencies, members and families to coordinate effective and clinically appropriate discharge plans.
Promote quality and cost effectiveness of healthcare by the appropriate application of policies and guidelines to prior authorization and concurrent review requests.
Perform reviews of psychotropic medication utilization to insure appropriate and clinically indicated uses of psychotropic medications.Review psychotropic medication utilization/prepare cases for Behavioral Health Medical DirectorPerform prior authorization reviewsPerform inpatient concurrent reviewsAssist with discharge planningEducation and Experience:Master’s degree in Behavioral Health (LICSW, LMFT, LMHC, LPC, PHD, PsyD) or graduate from an accredited school of Nursing.
Minimum of 3 years of experience in Mental Health or Substance Use Disorder treatment required.For Fidelis Care only: NYS LMFT, LCSW, LMSW, LMHC, Licensed Psychologist, or RN license required.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
