Job Summary

Job Profile Summary
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 involves 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 in-patient to out-patient office visits.

JOB REQUIREMENTS:
* Registered Nurse (RN) with current license or Masters-level Behavioral Health Professional with current license
to practice at the independent practice level. Current clinical license 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.

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Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Base Pay Range
$61,500.00 - $136,100.00

Exact compensation may vary based on skills, experience, and location.