Behavioral Health Utilization Management Jobs in Virginia

Position can be done Remote (work from home)

Education: Registered Nurse or Masters in Social Work, Counseling or Psychology.

Broad Knowledge of mental illness/substance use diagnosis and treatment protocols required.

Computer skills and an advanced understanding of the Electronic Health Records used by the department required.

The abilities to work independently to triage incoming requests and clearly communicate work assignments and priorities to the department are essential.

Overview: Behavioral Health (Utilization/Case Manager)

Provides educational services to the Utilization Management staff

Requires knowledge of managed care contracting, Medical Necessity, CMHRS services, DMAS protocols, clinical protocols and clinical review requirements

Minimum 1 year experience in Managed Care Setting (MCO)

First line supervisor in the Utilization Management Department

Provides a leadership role in ongoing utilization review competency assessment, needs identification and educational offerings

Requires knowledge of contractual, regulatory and compliance requirements for government payers, self funded and commercial payers

Position can be done Remote (work from home)

Education: Registered Nurse or Masters in Social Work, Counseling or Psychology.

Broad Knowledge of mental illness/substance use diagnosis and treatment protocols required.

Computer skills and an advanced understanding of the Electronic Health Records used by the department required.

The abilities to work independently to triage incoming requests and clearly communicate work assignments and priorities to the department are essential.

Overview: Behavioral Health (Utilization/Case Manager)