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:
* Masters-level Behavioral Health Professional (LPC, LMFT, LCSW, LCPC, RPsy) with current license to practice at the independent practice level OR Registered Nurse (RN) with Behavioral Health experience.
* Current clinical license in state of operations and in good standings.
* 3 years clinical experience (post licensure at the independent practice level) 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.
Dexian is a leading provider of staffing, IT, and workforce solutions with over 12,000 employees and 70 locations worldwide. As one of the largest IT staffing companies and the 2nd largest minority-owned staffing company in the U.S., Dexian was formed in 2023 through the merger of DISYS and Signature Consultants. Combining the best elements of its core companies, Dexian's platform connects talent, technology, and organizations to produce game-changing results that help everyone achieve their ambitions and goals.
Dexian's brands include Dexian DISYS, Dexian Signature Consultants, Dexian Government Solutions, Dexian Talent Development and Dexian IT Solutions. Visit https://dexian.com/ to learn more.
Dexian is an Equal Opportunity Employer that recruits and hires qualified candidates without regard to race, religion, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.
Job Types: Full-time, Travel nursing, Contract
Pay: $35.00 - $38.00 per hour
Expected hours: 40 per week
Medical specialties:
- Critical & Intensive Care
- Primary Care
Physical setting:
Standard shift:
Supplemental pay types:
Supplemental schedule:
Weekly schedule:
Application Question(s):
- THIS ROLE WILL TELECOMMUTE ON A FULL TIME BASIS WITHIN THE STATES OF NM, TX, OK, MT AND IL* *Please note that you MUST be licensed to practice at the independent level for this role.
Experience:
- Nursing: 4 years (Preferred)
License/Certification:
Willingness to travel:
Work Location: In person