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MHSU UM Care Reviewer


Vaya Health


Location

Wilmington, NC | United States


Job description

LOCATION: Remote – must live in North Carolina or within 40 miles of the NC border.

GENERAL STATEMENT OF JOB

The Mental Health/Substance Use (MH/SU) Care Reviewer is responsible for facilitating the review of service authorization requests and accompanying documents to ensure individuals are receiving the most appropriate services at a given time. This position screens authorization requests for completeness, recommends an administrative denial to the Licensed Care Managers for some requests based on review check- sheets, and refers requests that require clinical review to Licensed MH/SU Utilization Management Clinicians.

ESSENTIAL JOB FUNCTIONS

Review of Service Authorization Requests:
Monitor the Delivery of Monitored Services: Other Duties as Assigned.

KNOWLEDGE, SKILL & ABILITIES QUALIFICATIONS & EDUCATION REQUIREMENTS

Bachelor’s degree in Special Education, Psychology, Social Work or related Human Services area, and PHYSICAL REQUIREMENTS:

RESIDENCY REQUIREMENT:

This position is required to reside in North Carolina or within 40 miles of the North Carolina border.

SALARY: Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation.


DEADLINE FOR APPLICATION: Open Until Filled

APPLY: Vaya Health accepts online applications in our Career Center, please visit

Vaya Health is an equal opportunity employer.


Job tags

Remote job


Salary

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