JOB SUMMARY: Behavioral Health Utilization Manager will assist the overall Behavioral Health Program for Community Health Choice in the review of telephonic and faxed clinical information to authorize medically necessary inpatient and outpatient care, utilizing nationally recognized evidenced based clinical criteria or approved medical guidelines MINIMUM QUALIFICATIONS:
Work Experience (Years and Area): Two (2) years' experience in an acute psychiatric care setting. Two (2) years' experience in utilization review in a managed care environment with Medicaid and Medicare members.
Equipment Operated: Computer literate with knowledge of MS Word, MS Excel, Outlook, and telephone systems. Also able to navigate clinical platforms
Communication Skills: Above Average Verbal (Heavy Public Contact) Writing /Composing (Correspondence / Reports )
Other Skills: Analytical Dictation/Transcription Medical Terminology Research PC MS Word MS Excel
Advanced Education: Master's Degree Major: Social Work or related field
Work Schedule: Flexible
Other Requirements: Able to work independently under general instructions and working within a team environment. Ability to self manage while working remotely
The Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes 23 community health centers, five school-based clinics, a dental center and dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals.Ben Taub Hospital is a world renowned Level I Trauma Center with 586 licensed acute-care beds and provides a wide range of specialty care outpatient services. Lyndon B. Johnson Hospital is a 328 licensed bed acute-care hospital with a newly expanded Level III trauma center and a distinguished regional center for neonatal intensive care for high-risk deliveries.Harris Health is a teaching system for Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth). We train the next generation of healthcare providers on the latest medical procedures and technological breakthroughs.With... our fully integrated electronic medical records system, we offer patients the convenience and assurance that their medical history is accurate, safe and available when and where it is needed. Our Medical Home designation ensures that we offer a full range of preventive, specialty and acute care services for the entire family.