Duration: 12 Months
Job Description- Under the direction of the Supervisor – Behavioral Health, the Program Coordinator – Behavioral Health is responsible for the daily management of non-clinical reviews that support the clinical, business, and program-related work of the department.
- The Program Coordinator functions as a key member of the Behavioral Health Utilization Management (BH UM) team and represents Client Health values through professional written and verbal communication with both internal and external customers.
Key Responsibilities:Pre-Clinical Review Validation- Review incoming referrals and obtain required demographic information.
- Verify member eligibility.
- Identify special coverage or quality events and route cases appropriately.
Review Workflow Management- Manage departmental review workflows.
- Create and manage review events within clinical systems, including:
- Monitor review status and ensure timely processing.
Coverage Review- Perform basic coverage reviews for a defined subset of requests, including:
- Inpatient services
- Outpatient therapy
- ABA (Applied Behavior Analysis)
- CBHI/BHCA (Behavioral Health Services for Children and Adolescents)
- Psychological and neuropsychological testing
- rTMS (Repetitive Transcranial Magnetic Stimulation)
- Other levels of care as assigned
- Update requests, obtain additional clinical information, or void requests when appropriate.
Operational & Administrative Support- Participate in departmental operational and administrative processes.
- Respond to requests for departmental information and follow up as needed.
- Participate in departmental projects and special assignments to support timeliness, quality, and compliance.
- Represent the department on committees when required.
- Perform other administrative duties and special projects as assigned.
About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit
www.ustechsolutions.com .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
AI Statement: By applying, you acknowledge that AI-assisted tools may be used during hiring.
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