Tennessee Licensed Behavioral Health Manager

To support the management of care decisions, the full-time Tennessee Licensed Behavioral Health Manager will work remotely, utilizing their expertise in behavioral health and withdrawal management to assist with clinical reviews and coordinate care effectively. Key responsibilities Assist non-clinical staff in performance of administrative reviews and initiate referrals for care coordination Perform comprehensive provider and member appeals, denial interpretation, and retrospective claim reviews using clinical judgment Present cases during clinical rounds and navigate the continuum of care for behavioral health and withdrawal management Required qualifications Current, active unrestricted Tennessee license in Nursing (RN) or a master's level behavioral health field (e.g., LCSW, LPC) 3 years of clinical behavioral health or substance use disorder experience 1 year of knowledge regarding community care resources and levels of behavioral health care Experience in psychiatric and/or substance use treatment settings Prior experience in Utilization Management or Managed Care