Knowledge of:
Service Authorization concepts, principles, and strategies
Advanced knowledge of the behavioral health service delivery system and the needs of children and the needs of individuals designated as SMI
Principles of behavioral health management and assessment
Individual service planning process and substance abuse treatment
HCPCS codes Levels I & II and, knowledge of International Classification of Diseases, DSM IV/V coding and medical billing guidelines
Medical technology, computer data retrieval and input, including EHR, HIE, etc
Medicaid and Medicare Federal Regulations, State Statute, Rules, and Policies applicable to the Client Health Care Cost Containment System programs
Client Health Care Cost Containment System program design and implementation, prior authorization functions and responsibilities, provider network, and funding source
Familiarity with American Indian Tribes, programs and policy

Skills in:
Problem solving identification, evaluation, and imitation of appropriate action and case management assessment
Excellent verbal/written communication skills, with FFS Providers
Organizational skills to coordinate, monitor and report on multiple cases simultaneously
Analytical skills to identify and correlate specific patterns, initiate investigations, submit findings and recommendations
Strong interpersonal skills in working with people of diverse cultures and socioeconomic backgrounds
Documentation, research, and reporting of data and trends
Strong computer skills including Microsoft and Google Suite

Ability to:
Strong ability to collaborate with others for mutually beneficial outcomes
Interpret clinical information and assess implications for treatment
Read, interpret, and apply complex rules and regulations
Independent decision making yet knowing when to elevate the decision
Drive long distances when required
Ability to work Telecommute

Requirements:
Quality Management and/or Compliance Certification within the field of behavioral health, or Behavioral Health Professional (independent/associate license within AZ).
License Behavior Health: Will accept an independent or associate level license in good standing in AZ (any of the following with the Board of Behavioral Health: LAC or LPC, LIAC or LAAC (used to be LISAC or LASAC), LMSW or LCSW, LAMFT or LMFT).
Minimum: Two to three years clinical and programmatic experience working with the behavioral health service delivery systems.
Outpatient behavioral health experience

Preferred:
Advanced experience in clinical and/or claims supportive documentation review and analysis.

Notes:

Schedule:
Remote Position, Equipment is provided by facility, resource would need to pick up the equipment on first day.
8 hours per day, 40-hours per week, Monday - Friday - Work hours are flexible to start earlier if resource prefers
No weekends.