Kaiser Permanente
Utilization Management Specialist - Mental Health - Scheduled On Call (Remote - Local residency required)
This job is now closed
Job Description
- Req#: 1334995
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on patient care and outcomes
- Engage in meaningful work within the mental health and chemical dependency field
- Participate in a dynamic team focused on improving healthcare delivery
What to Expect (Job Responsibilities):
- Manage behavioral health benefits by providing medical necessity determinations and authorizations
- Facilitate member contact for benefit explanations, resource identification, and appointment scheduling
- Consult with internal and external providers on medical necessity interpretation and available resources
- Ensure proper expenditure of healthcare dollars while adhering to rules and regulations
- Coordinate care and communication among service providers to ensure continuity of care
What is Required (Qualifications):
- Minimum three (3) years of experience working with individuals with mental health or chemical dependency conditions
- Minimum two (2) years of experience in utilization management and discharge planning
- Master's degree in mental health, social work, or a closely related field from an accredited institution
- Understanding of medical necessity criteria and its application
- Excellent oral and written communication skills, with strong problem-solving abilities
How to Stand Out (Preferred Qualifications):
- Minimum five (5) years of experience working with individuals with mental health or chemical dependency conditions
- Current, unrestricted license/certificate in the state where job is assigned (e.g., LCSW, LMFT, LPC, or equivalent)
- Knowledge of Milliman Criteria, ASAM Criteria, and insurance operations
- Experience working with providers within contractual relationships
- Ability to issue and explain adverse benefit determinations
#HealthcareServices #MentalHealth #CareerOpportunity #UtilizationManagement #Teamwork
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