A Behavioral health Utilization Management and Care Coordinator is responsible for the timely coordination of quality behavioral health and substance use disorder treatment services for plan membership in a cost-effective manner to promote positive outcomes. Performs utilization and care coordination for members with behavioral health needs and substance abuse disorders by assessing levels of care, and by developing, implementing, coordinating, monitoring, and evaluating plan of care designed to optimize member’s treatment across the continuum. Evaluates requests for services for clinical appropriateness and medical necessity. Responsible for authorizing cases according to approved criteria across the continuum of care to ensure a positive member outcome while controlling costs by performing inpatient and outpatient reviews, and identification and referral of members appropriate for case management.
MINIMUM EDUCATION REQUIREMENTS
SPECIAL KNOWLEDGE AND/OR SKILLS
Virginia Premier is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs. Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia.
We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.
All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE
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