Behavioral Health Utilization Management Coordinator

Profile

Description

Location:

All clinical positions are located on site at our Dublin, Ohio campus

We’re on a mission to make healthcare simpler and more effective. We fight to ensure our members get the care they need, when they need it, at the most affordable cost – that’s what makes us Healthcare Warriors™. If you’d like to join us, we’d love to talk to you – even if you don’t match every single requirement.

Behavioral Health Care Coordinators (UMC)

are licensed healthcare professionals (Registered Nurses/RNs and Licensed Social Workers/LSWs) that provide our members with post-discharge behavioral health/substance abuse care coordination to ensure a safe and effective transition to the next level of care. They’re tech-savvy helpers, investigators and problem solvers. They interact with our members, clinicians and service providers on the phone, using leading technology to simplify the complex healthcare landscape.

What you’ll do

Provide post discharge calls and assistance to members that have been engaged in recent behavioral health/substance abuse treatment.

Assess members’ behavioral health crisis states and respond appropriately to ensure member wellbeing and safety.

Assess member’s psychosocial support system and provide member and support resource assistance with discharge planning, crisis planning, and related needs.

Interpret plan information and assist members with navigating barriers to obtaining appropriate outpatient behavioral health/substance abuse treatments and medication regimens; Refer members to available resources for continued support and optimal well-being.

Interprets available clinical data to determine appropriateness of PDC outreach.

Provide resources for education areas about relevant health topics that may impact the member and plan of care, including levels of care, need for continuation of care, medications, etc.

Maintain contact with internal clinical staff for transfer of cases for medical management when appropriate.

Use Quantum Health's systems and technology to accurately document all interactions related to patient care.

All other duties as assigned.

What you’ll need

Education / Licensure: Active license in good standing as a Registered Nurse (RN) or Licensed Social Worker (LSW) in Ohio required; undergraduate degree in a related field preferred.

Experience: Minimum of 4 years’ professional clinical experience in a Behavioral Health practice setting.

Strong working knowledge of nationally accepted Behavioral Health medical necessity criteria

Demonstrated ability to work with diverse populations and cultural backgrounds.

Strong administrative/technical skills; Comfort working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), IM/video conferencing (Teams & Zoom), and telephones efficiently.

Excellent verbal and written communication skills, including motivational interviewing expertise. Comfortable communicating with members and providers via phone regularly throughout the day. Ability to work independently with minimal supervision

Trustworthy and accountable behavior, capable of viewing and maintaining confidential personal information daily.

What’s in it for you

Compensation:

Competitive base pay, incentive plans and employee referral bonuses.

Coverage:

Health, vision and dental featuring our best-in-class healthcare navigation services, along with life insurance, legal and identity protection, adoption assistance, EAP, Teladoc services and more.

Retirement:

401(k) plan with up to 4% employer match and full vesting on day one.

Balance:

Paid Time Off (PTO), 7 paid holidays, parental leave, volunteer days, paid sabbaticals, and more.

Development:

Tuition reimbursement up to $5,250 annually, certification/continuing education reimbursement, discounted higher education partnerships, paid trainings and leadership development.

Culture:

Recognition as a Best Place to Work for 15 years, dedication to

diversity, philanthropy and sustainability

, and people-first values that drive every decision.

Environment:

A modern workplace with a casual dress code, open floor plans, full-service dining, free snacks and drinks, complimentary 24/7 fitness center with group classes, outdoor walking paths, game room, notary and dry-cleaning services and more! Check out our home:

https://youtu.be/xRnbvCW_YgA

What you should know

Internal Associates:

Already a Healthcare Warrior? Apply internally through Jobvite.

Process:

Application > Phone Screen > Online Assessment(s) > Interview(s) > Offer > Background Check

Diversity, Equity and Inclusion:

Quantum Health welcomes everyone. We value our diverse team and suppliers, we’re committed to empowering our ERGs, and we’re proud to be an

equal opportunity employer

Agencies:

Quantum Health does not accept unsolicited resumes or outreach from third-parties. Absent a signed MSA and request/approval from Talent Acquisition to submit candidates for a specific requisition, we will not approve payment to any third party.

Sponsorship:

Applicants must be legally authorized to work in the United States on a permanent and ongoing future basis without requiring sponsorship.

#LI-HW1 #LI-Onsite

Note:

Compensation information published by job boards are estimates and not verified by Quantum Health. Details surrounding compensation will be disclosed throughout the interview process. Compensation offered is based on the candidate’s unique combination of experience and qualifications related to the position.

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Company info

Quantum Health LLC.
Website : http://quantum-health.com