Behavioral Health Consultant
About The Position
We are excited to be seeking a highly motivated Behavioral Health Consultant for our clinical organization in a remote environment. As a Behavioral Health Consultant, you will be part of a growing mental health team within the Group Protection Clinical organization. You will collaborate with Independent Consulting Physicians, Claims Specialists, and Nurse Disability Consultants to assist with reviewing and assessing mental health disability claims. You will act as a resource to review, analyze, and interpret medical information as well as assess ongoing interventions and functional capacity for psychiatric, social, psychological, and vocational areas.
Requirements
- 4 Year/Bachelor's degree or equivalent work experience (4 years of experience in lieu of Bachelor's) in Nursing.
- 3+ Years experience in behavioral health including 1 year in claims, disability management (STD/LTD), workers comp, utilization review, and/or behavioral health nurse case management.
- Ability to read, analyze and interpret both internal and external documents such as general media/publications, professional journals, technical procedures, governmental regulations, policies, proposals, and standard operating procedures.
- Confident, comfortable communicator with strong written and verbal communication skills.
- Demonstrates clear, concise communication skills when interpreting medical information, documenting rationales for clinical opinions, clarifying restrictions/limitations, assisting with return to work and communicating with staff, mgmt. & other stakeholders
Nice To Haves
- Master’s degree in a human services-related field, such as social work, clinical psychology, or mental health counseling, and licensure in clinical psychology or social work (e.g., LICSW, LCMHC, LPC, or LMFT).
- Previous insurance industry experience preferred.
Responsibilities
- Serve as the behavioral health clinical expert for claim professionals, providing consultation on behavioral health conditions, work capacity, restrictions and limitations, impairment, and return-to-work opportunities.
- Review, interpret, and evaluate behavioral health clinical information to support effective claim management and determine the appropriateness of ongoing restrictions, limitations, and impairment levels.
- Collaborate with claim professionals, physician consultants, vocational rehabilitation partners, healthcare providers, and other stakeholders to support optimal claim outcomes and return-to-work strategies.
- Communicate with claimants, employers, and healthcare providers to obtain, clarify, and educate others on the medical information needed to support claim decisions and behavioral health assessments.
- Provide coaching, guidance, and clinical recommendations to claims partners, including referrals to appropriate internal and external clinical resources when needed.
- Manage a complex caseload while meeting productivity, quality, and service expectations and ensuring timely, accurate clinical reviews.
- Identify process improvements, support departmental and enterprise initiatives, and positively influence change to enhance quality, efficiency, and customer outcomes.
- Serve as a trusted resource and mentor to team members, continuously expanding your expertise and sharing knowledge on emerging behavioral health trends and best practices.
Benefits
- PTO/parental leave
- Competitive 401K and employee benefits
- Free financial counseling, health coaching and employee assistance program
- Tuition assistance program
- Work arrangements that work for you
- Effective productivity/technology tools and training
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
