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 healthcare organization as a Care Manager, where you will have the opportunity to make a significant impact on the lives of our members. In this vital role, you will oversee 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 integrity 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 decisions clearly.
? Accurately document all 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 decisions 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 when 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.
? Inspire and motivate team members and external committees.
? Demonstrate proficiency in Microsoft Office Suite (Word, Outlook, Excel, PowerPoint) and related applications.
Qualifications
? A Master?s degree in psychology, social work, counseling, or a related field, along with a minimum of four years of experience in providing ABA or mental health services, including clinical review and treatment plan oversight.
? Current, 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 skill enhancement and career advancement within the healthcare 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 healthcare community.
Compensation And Benefits
? Competitive salary commensurate with experience.
? Comprehensive health, dental, and vision 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
Similar Remote Jobs
Care Representative Customer Service (Remote)
Posted on: 07-11-2024 05:43
REMOTE PER DIEM BCBA POSITION
Posted on: 07-11-2024 05:43
Work From Home Personal Assistant
Posted on: 07-11-2024 05:43
Systems Engineer 3/ UI Path
Posted on: 07-11-2024 05:43
Central Quoting Supervisor - Flooring
Posted on: 07-11-2024 05:43
Flexible schedule remote Health Advocate
Posted on: 07-11-2024 05:43
Driver Partner - Part Time
Posted on: 07-11-2024 05:43
Driver Partner - Part Time
Posted on: 07-11-2024 05:43
Driver Partner - Part Time
Posted on: 07-11-2024 05:43
Florida Disney Warehouse Jobs $24/Hour
Posted on: 07-11-2024 05:43
Part Time Email Designer
Posted on: 16-11-2024 00:00
Accounts Receivable Representative *Remote, Full Time, Day Shift
Posted on: 28-10-2024 09:49
Amazon Account Manager - Virtual/Remote
Posted on: 16-07-2024 18:35
Southwest Airlines Data Entry Job ||Remote|| - Big Data Analyst
Posted on: 16-07-2024 18:51
Customer Service Specialist – Flexible Hours
Posted on: 12-09-2024 00:00
Amazon Media Manager-Joico
Posted on: 20-01-2025 00:00
Work At Home Data Entry Remote Administrative Assistant Job at FocusGroupPanel i
Posted on: 06-12-2024 06:00
Customer Service Representative Overnight (Remote in Hollywood, FL)
Posted on: 16-07-2024 19:06
Sr. Manager, Product Manager - Tech, Amazon People Engagement/People Experience Foundation (PXF)
Posted on: 22-09-2024 00:00
Remote Job For Netflix, Be A Netflix Tagger, Netflix careers Apply Now
Posted on: 21-02-2025 00:00