Behavioral Healthcare Coordinator

Posted: 05/30/17 | SHARE:

Description:

The Behavioral Health Care Coordinator (BHCC) is responsible for on-site or telephonic utilization management. The BHCC performs reviews of preauthorization, current and discharge for inpatient Mental Health and Substance Abuse services following evaluation of Milliman Level of Care Guideline and benefit determination. Monitoring quality outcomes that include 30 day readmission, post hospital follow-up and length of stay. Participates in quality management activities through documentation of initiatives, reporting and analysis of data, on-site quality initiatives in behavioral health inpatient facilities and hospitals. Responsible for working strategically and on-site in a consultative role with our large volume hospitals and outpatient providers to develop treatment plans to allow the members to function in the least restrictive level of care. Participates in quality management activities through working with facilities to improve HEDIS quality performance, reporting and analysis of data.

Qualifications:

  • Bachelor’s degree required. Advanced degree preferred.
  • Master’s prepared mental health clinician (LCSW, LMSW or LMHC) or licensed Registered Nurse (RN) required (may be substituted for a Bachelors/Master’s).
  • Minimum 2 years clinical utilization management/case management experience required.
  • New York State licensure with a minimum 1 year direct service experience in the delivery of mental health and substance abuse treatment services required.

 

Salary Grade: 15

As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law.

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