Behavioral Health Specialist

Job Posting Title Behavioral Health Specialist Agency 807 HEALTH CARE AUTHORITY Supervisory Organization Behavioral Health Full/Part-Time Full time Job Type Regular Compensation $65,607.00/annual Why You’ll Love Working Here At the Oklahoma Health Care Authority (OHCA), your work matters. Every day, our team helps ensure Oklahomans have access to better health and better care. Guided by our core values, Passion for Purpose, Trust & Transparency, Empowerment & Accountability, Best-in-Class, Outcome-Driven, and Servant Leadership , we foster a workplace where people feel supported, respected, and empowered to make an impact. Learn more about OHCA. Benefits Generous state-paid benefit allowance to offset insurance premiums. A wide selection of insurance plans with no pre-existing condition exclusions. Flexible Spending Accounts for health care and dependent care. Retirement Savings Plan with employer contributions. 11 paid holidays annually. 15 days of vacation and 15 days of sick leave in the first year. Longevity Bonus recognizing years of public service. Public Service Loan Forgiveness eligibility and tuition reimbursement. Wellness benefits, including an on-site gym and fitness center discounts. Job Details Location: 4345 N Lincoln Blvd, Oklahoma City, OK 73105 Salary: $65,607.00/annual Work Schedule: Monday – Friday Primary Hours: 8:00 a.m. – 5:00 p.m. Agency/Division Information The Oklahoma Health Care Authority (OHCA) works to ensure Oklahomans have access to better health and better care. The agency’s core values include passion for purpose, trust and transparency, empowerment and accountability, best in class and outcome-driven, and servant leadership. As part of the interview process, candidates may be required to attend an in-person interview at our Oklahoma City office. Position Purpose The Behavioral Health Specialist is responsible for evaluating the medical necessity, appropriateness, and quality of care for members receiving behavioral health services. This role involves conducting clinical record reviews, liaising with providers, and assessing member needs to ensure effective care delivery. By monitoring treatment progress, addressing barriers to care, and identifying necessary services, the specialist supports optimal health outcomes. Additionally, the position aims to foster collaborative relationships both within and outside the organization, contributing to continuous improvement of behavioral health services in alignment with the Oklahoma Health Care Authority’s mission to provide better health and care for Oklahomans. Principal Activities Evaluate medical necessity, care appropriateness, and quality through clinical record analysis and provider communication. Distinguish between convenience and necessity ensuring clear and professional communication with providers. Monitor treatment progress and engagement, assessing ongoing member needs through regular contact with involved parties. Link members to necessary services by identifying treatment needs and available resources. Identify and address barriers to provider participation and member access, offering recommendations for policy improvement. Address issues affecting member participation and access to services. Cultivate effective relationships within and outside the organization to fulfill responsibilities effectively. Foster partnerships internally and externally to optimize member support. Optimize member care delivery through integrated management of pre-approvals, quality control, and care coordination activities. Other duties as assigned. Supervisory Responsibilities This position does not supervise. Knowledge, Skills, Abilities and Competency Requirements The Behavioral Health Specialist position requires in-depth knowledge of clinical and behavioral health practices, state and federal healthcare policies, and program administration. Key skills include the ability to evaluate care quality, communicate effectively with providers, and coordinate services across various stakeholders. The role aligns with the Decision Quality and Collaborates Korn Ferry competencies, as it requires sound clinical decision-making and strong collaboration with internal and external partners to ensure optimal care delivery. To be considered for this position your application must include a resume/CV with complete work and education history. Position Structure This post is intended to fill multiple positions within the Behavioral Health Unit. Selected candidates will be assigned to a specific functional track at the time of hire, based on program need and candidate experience. Each track represents a distinct area of responsibility within the program. Functional Tracks Prior Authorization – This role focuses on providing clinical determinations for prior authorizations including inpatient psychiatric treatment, electroconvulsive therapy (ECT), and therapeutic foster care (TFC). Responsibilities include reviewing clinical records, certificates of need, and direct contact with providers as necessary. This position involves distinguishing between convenience, medically necessary services, communicating effectively and timely to providers, and ensuring that members are receiving the most appropriate level of care. This position is open to licensed mental health professionals Applied Behavioral Analysis (ABA) – This role focuses on providing clinical determinations for applied behavioral analysis. Responsibilities include evaluating authorization requests for ABA assessments and treatment services to ensure they meet medical necessity criteria, benefit plan requirements, and regulatory standards. This role supports appropriate utilization of ABA services by reviewing clinical documentation, applying evidence-based guidelines, and collaborating with providers to ensure effective and timely treatment are being provided. Preference may be given to a Board-Certified Behavioral Analyst (BCBA) or a licensed mental health professional with clinical experience in treating Autism Service Quality Review – This role focuses on evaluating the quality, appropriateness, and effectiveness of inpatient psychiatric services, applied behavioral analysis, and Residential Substance Use Disorder treatment. This role ensures that providers adhere to clinical best practices, payer policies, regulatory requirements, and evidence-based standards. The position will conduct retrospective reviews, analyze treatment outcomes, and support the quality improvement initiatives across each of these levels of care. This position is open to licensed mental health professionals and Registered Nurses with a valid license. Education and/or Experience Current and valid behavioral health licenses such as: Licensed Professional Counselor (LPC) or Licensed Clinical Social Worker (LCSW), or Licensed Marriage and Family Therapist (LMFT), Board Certified Behavior Analyst (BCBA) AND. Master’s degree in psychology, counseling, human relations, clinical/direct practice social work, or a closely related field which must have included one semester of at least three hundred hours of applied clinical practicum in psychology or counseling plus one-year post-master’s experience providing professional counseling services OR. Registered Nurse in the state of Oklahoma. Preference Qualifications Certifications in any of the following areas: Certified Case Manager (CCM), Certified Addiction Specialist (CAS), or Crisis Prevention and Intervention (CPI) Certification. SoonerCare experience. State or federal government work experience. Experience with an integrated healthcare delivery system. Experience inutilizationmanagement and/or inpatient psychiatric hospital position. Experience in care coordination/case management. Physical Demands and Work Environment Work is typically performed in an office setting with climate-controlled settings and exposure to moderate noise levels. In the course of performing job duties, employees are required to speak, stand, walk, and reach with their hands and arms. This position requires extended periods of sitting and daily use of computers and phones. Employees must be willing to complete all job-related travel associated with this position. Being present at the office is an essential function of this position. Accommodation Statement The Oklahoma Health Care Authority complies with applicable State and Federal civil rights laws and does not discriminate. All qualified applicants will receive consideration for employment without regard to race, color, sex, religion, disability, age, national origin, or genetic information. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact the Civil Rights Coordinator at View phone number on click.appcast.io. Equal Opportunity Employment The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability. Internal Applicants Current State of Oklahoma employees must apply for open positions internally through Workday Jobs Hub. #J-18808-Ljbffr