This position is a hybrid role that combines the roles and expertise of Utilization Review and Care management. This role is essential in ensuring that members receive high-quality, cost-effective care. Overall, utilization management is an essential process that not only ensures the medical necessity of care but also assists in monitoring and controlling healthcare costs while prioritizing member safety. These processes involve detailed assessments, evidence-based guidelines, and coordination among various healthcare professionals to achieve optimal outcomes for members. The ideal candidate will possess a strong understanding of utilization management principles, as well as a solid foundation in healthcare operations and regulatory compliance. Candidates will apply expertise to review medical records and treatment plans for individuals with specific conditions or diagnosis including medical and behavioral health conditions to ensure that services are medically necessary, appropriate, and cost-effective. This position is a hybrid role that combines the expertise of a Licensed and Masters Prepared Behavior Health Specialist with Utilization and Care management. This role is essential in ensuring that members receive high-quality, cost-effective care. The ideal candidate will possess a strong understanding of Applied Behavior Analysis (ABA) principles, as well as a solid foundation in healthcare operations and regulatory compliance. Candidate will apply expertise in Applied Behavior Analysis (ABA) to review medical records and treatment plans for individuals with autism and other behavioral health conditions to ensure that services are medically necessary, appropriate, and cost-effective. To show our commitment to you and to assist with your transition into our organization, we will also offer a $2500 sign on bonus to those that have 1+ year of experience. (External applicants only.) Job Specifics Pay Range Clinical: $38.77 - $59.82 Exempt Benefits Eligible: Yes FTE: Full time Shift: Hybrid Role. Monday - Friday, 8:00am - 4:30pm. (Schedule finalized on hire) Occasional weekends and Holidays. Click learn about additional Intermountain benefits BCBA Licensure REQUIRED
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Job Type
Full-time
Career Level
Mid Level
Number of Employees
5,001-10,000 employees