Description:This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members on the telephone, reviewing medical records, reviewing cases which involve contract interpretation of behavioral health diagnoses, and utilizing knowledge of medical necessity criteria for all levels of behavioral health care from outpatient office visits to acute inpatient.
JOB REQUIREMENTS:Registered Nurse (RN) with active, current license or Masters-level Behavioral Health Professional with active, current license to practice at the independent practice level. Current clinical license to practice in state of operations and in good standings.3 years clinical experience in psychiatric setting or own behavioral health practice.Verbal and written communication skills.Analytical and decision making skills.PC and database experience.
PREFERRED JOB REQUIREMENTS:Utilization review experience.Required Qualification(s)BH experience, managed care preferredNotes:Contract to Hire
At VIVA, employee well-being is paramount. Our comprehensive benefits package ensures your health, financial security, and quality of life are always prioritized.
VIVA provides employees access to a comprehensive group health insurance plan (Medical, Dental, Vision, Basic Life, Term Life, and Accidental Death) through our flexible PPO plan-allowing you the freedom to choose healthcare providers.
Plan securely for your future with automatic payroll deductions into a tax-advantaged 401(k) retirement plan, including employer-matching contributions for eligible employees.
Earn performance-based bonuses and generous referral incentives of up to $500 when recommending talented candidates who become part of the VIVA family.
Enjoy timely and convenient payroll with biweekly direct deposit to your chosen financial institution. Biweekly Direct Deposit
Access exclusive employee discounts and savings on electronics, travel, groceries, apparel, and more through our dedicated VIVA Perks Program.