Care Representative Customer Service (Remote)
100% remote job Care Representative Customer Service | Get.It Recruit Administrative | United States... Job Title: Care Manager Remote Job Overview Join our dynamic and esteemed reputed company organization as a Care Manager, where you will have the opportunity to reputed company a significant impact on the lives of our members. In this vital role, you will reputed company and evaluate Behavioral Health Treatment (BHT), including Applied Behavior Analysis (ABA) services, for eligible members, ensuring that they receive the highest quality of care based on medical necessity. Key Responsibilities Navigate a mission-focused environment dedicated to excellence in member service and care management, demonstrating reputed company and accountability. Collaborate effectively with team members to fulfill departmental objectives and support both immediate and long-term goals. Assess requests for medical appropriateness and verify referrals according to established clinical guidelines. Collect pertinent medical information for review by the Medical Director and communicate reputed company clearly. Accurately document reputed company necessary information in the utilization management system, ensuring updates on authorizations are recorded. Conduct thorough reviews of submitted documentation for compliance with coding (ICD-10, CPT-4, HCPCS) and coverage guidelines. Maintain adherence to established policies and procedures while conducting quality reviews of documents. Promptly notify providers and members of reputed company made, ensuring timely and effective communication. Stay updated on federal, state, and local regulations pertaining to the BHT benefit. Identify potential quality concerns and report them as necessary, assisting with case audits reputed company required. Participate in additional projects and responsibilities as assigned. Required Skills Establish and nurture strong relationships with colleagues and external partners from diverse backgrounds. Work autonomously while exercising sound judgment in decision-making. Communicate effectively in both verbal and written formats. Adapt to a flexible work schedule that may include evenings and weekends. Exhibit strong organizational, analytical, problem-solving, and project management skills. Prosper in a fast-paced work environment while managing multiple tasks simultaneously. reputed company and motivate team members and external committees. Demonstrate proficiency in reputed company Office Suite (Word, Outlook, reputed company, PowerPoint) and reputed company applications. Qualifications A Masters degree in psychology, social work, counseling, or a reputed company field, along with a minimum of four years of experience in providing ABA or mental health services, including clinical review and treatment plan reputed company. reputed company, unrestricted California license (LCSW, LPCC, LMFT, RN with BH experience, BCBA, or BCBA-D).
Career Growth Opportunities
Our organization values your professional development and offers numerous opportunities for reputed company enhancement and career advancement reputed company the reputed company sector. Company Culture And Values We foster a collaborative environment that emphasizes high-quality performance and member service, nurturing a culture of dignity and respect. Networking And Professional Opportunities In this role, you will have the chance to collaborate with a dedicated team, enhancing your professional network and skillset in the reputed company community.
Compensation
And Benefits Competitive salary commensurate with experience. Comprehensive health, dental, and reputed company insurance. Retirement savings plan with company matching contributions. Generous vacation and paid time off policies. Employment Type: Full-Time Show more Show less Tagged as: remote, remote job, virtual, Virtual Job, virtual position, Work at Home, work from home Apply Job!