• Behavioral Health Utilization Specialist

    Job Locations US-WI-Madison
    ID
    2019-1107
    Category
    Clinical Services
    Type
    Regular Full-Time
  • Overview

    Quartz is seeking a licensed mental health professional to join our organization as a Behavioral Health Utilization Specialist. This role is responsible for conducting clinical review of authorization requests to identify appropriate types and levels of mental health/AODA services for members. This role also facilitates referrals between health plan members, participants, primary care physicians and other health care providers.

    Responsibilities

    • Manage the utilization of mental health/AODA services by assessing members’ needs for services through phone interviews, clinical documentation review and collaboration with treating providers
    • Utilizes clinical judgment and knowledge of established standards to determine the medical necessity of treatment requests for services requiring prior authorization
    • Obtain accurate and detailed clinical information from appropriate sources to facilitate clinical review of cases; maintain information for reporting purposes
    • Maintain confidentiality and adhere to the professional standards and ethics of the mental health field and managed care industry
    • Review outpatient treatment when utilization exceeds established standards of care

    Qualifications

    • Master’s Degree in a mental health-related field
    • Licensed Mental Health Professional – Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC) or Licensed Marriage and Family Therapist (LMFT) required
    • 5+ years of post-Master’s Degree experience in a behavioral health care setting
    • Experience providing substance use disorder treatment is preferred
    • Strong written and verbal communication skills interacting with individuals internally and externally
    • Strong independent, critical thinking skills to understand individual and operational problems and identifying appropriate solution(s)

     

    Applicants will work full-time from our office in Madison, WI. Quartz offers an excellent benefit and compensation package, opportunity for professional growth and a professional culture built upon the foundation of Respect, Responsibility & Relationships.

     

    Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity, Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

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