Clinical Services Coordinator, Intermediate (BH Specialty TOC )

Your Role

The Behavioral Health Services (BHS) Specialty team provides support to the clinical Behavioral Health Utilization Management team and processes exception requests. The Behavioral Health (BH) Clinical Services Coordinator (CSC), Intermediate will report to the BH Manager of the Specialty team. In this role you will provide administrative support to the Behavioral Health Utilization Management clinical team related to facility-based discharge planning, managing the clinical attachments and assisting with transitions of care.

Your Work

In this role, you will:

• Work in a production-based environment with defined production and quality metrics
• Partner with Behavioral Health UM Clinicians to conduct outreach calls to facilities to confirm member status and identify discharge planning needs
• Process medical record submissions, complete system documentation and coding updates, and issue correspondence
• Conduct research in various systems
• Provide administrative support to Behavioral Health Utilization Management Clinicians

Other duties as assigned

Your Knowledge and Experience

• Requires a high school diploma or equivalent
• Requires at least 3 years of prior relevant experience
• Understanding of behavioral health facility-based levels of care preferred
• Working knowledge of the systems/tools utilized for UM authorization functions such as FACETS, MedHok, preferred
• Knowledge of health plan terminology preferred
• Ability to work in a high-paced production environment with occasional overtime needed (including weekends) required