Behavioral Health Consultant

Behavioral Health Consultant

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.

You will 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. You will review, interpret, and evaluate behavioral health clinical information to support effective claim management and determine the appropriateness of ongoing restrictions, limitations, and impairment levels. You will collaborate with claim professionals, physician consultants, vocational rehabilitation partners, healthcare providers, and other stakeholders to support optimal claim outcomes and return-to-work strategies. You will 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. You will provide coaching, guidance, and clinical recommendations to claims partners, including referrals to appropriate internal and external clinical resources when needed. You will manage a complex caseload while meeting productivity, quality, and service expectations and ensuring timely, accurate clinical reviews. You will identify process improvements, support departmental and enterprise initiatives, and positively influence change to enhance quality, efficiency, and customer outcomes. You will 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.

Must-have experience (Required): 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 have experience (Preferred): 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.