UM Clinician - Metro Louisville candidates only will be considered

Job Description:

ESSENTIAL JOB FUNCTIONS

Reviews UM reports on a daily basis. Interacts with UM counterparts at Managed Care Organizations (MCO) on all aspects of MCO's UM processes. Assists in ensuring MCO authorization for all services provided to CKY clients with Medicaid or other insurance payer. Interacts with individual clinicians to provide ongoing education and improve their functioning in a UM environment. Interacts with outpatient clinicians to prepare and submit appeals of all authorization denials by reviewing documentation (e.g., treatment plans and progress notes) Assists in preparing standard and PRN reports related to UM performance on division, unit, or individual basis. Assists in identifying clinician outliers related to all aspects of the UM process.

The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description.


EDUCATION

• Bachelor's or Master's Degree in nursing, social work, psychology, or related field consistent with educational requirements of Qualified Mental Health Professional (QMHP) or Qualified Mental Retardation Professional (QMRP).
• Licensure or certification, as required for QMHP, including: Licensed Psychological Practitioner, Certified Psychologist, Licensed Psychological Associate, LCSW, CSW, LMFT, LPCC, LCADC.

EXPERIENCE

• Four to six years of clinical experience.
• Utilization management experience preferred, but not required.
• Solid knowledge of UM principles and protocols.
• Good communication and interpersonal skills.

PHYSICAL DEMANDS

• Position requires lifting of 20 pounds maximum, with frequent lifting and/or carrying of items weighing up to 10 pounds.
• Occasional minor discomforts from continual exposure to video display terminal.

Within the bounds of their respective job descriptions, all staff are expected to exercise principle-centered leadership, focused on customer service responsiveness, with a continuous quality improvement orientation. Additionally, all staff are expected to develop a working knowledge of and follow all policies and procedures related to safety management and other Joint Commission standards.


Time Type:
Full time

We continually help our community and employees flourish... one life at a time. As a Seven Counties Services employee there are many benefits to enjoy. Below are just some of the great benefits you might be eligible for with Seven Counties Services.

• Health & Wellness
  • Medical Coverage
  • Dental Coverage
  • Vision Coverage
  • Flexible Spending Account
  • Health Savings Account
  • Short Term Disability
  • Long Term Disability - Company Paid

• Financial Wellbeing
  • Competitive Compensation Packages
  • Life Insurance - Company Paid
  • Accidental Death & Dismemberment Insurance - Company Paid
  • 403b Retirement Plan with Company Funded Matching
  • Retirement and Financial Planning Services

• Career Development and Growth
  • Tuition Assistance Plans
  • Loan Forgiveness options through federal programs ( National Health Service Corp s & Public Service Loan Forgiveness )
  • Student Loan Repayment Assistance
  • Clinical Supervision toward licensure and reimbursement for certain license applications
  • At Seven Counties Services training is one of our highest priorities. We provide company paid professional training for various skills, certifications, and continuing education
  • Opportunities for growth and movement - We encourage our employees to consider new growth opportunities with us
  • Leadership Academy for our rising stars, supervisors, and leaders
  • Seven Counties Services and Center for Clinical Excellence provide staff with industry best practices and processes

• Work Life Balance
  • Paid Time Off - Generous PTO for Vacations, Illness, Personal Days, Etc. (10 Paid Holidays )
  • Flexible Work Schedules to promote a Healthy Work Life Balance
  • Employee Assistance Program - assists employees with personal problems and/or work-related problems that may impact their job performance, health, mental and emotional well-being

At Seven Counties Services, we are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and employees without regard to race, color, religion, sex, pregnancy (including childbirth, lactation and related medical conditions), national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military and veteran status, and any other characteristic protected by applicable law.