Rutgers, The State University of New Jersey is seeking a Mental Health Clinician III for the Managed Care Services – Interim Managing Entity Program at Rutgers, University Behavioral Health Care.
The primary purpose of the Mental Health Clinician III is to perform clinical utilization reviews with providers of care for: entry into all levels of care based on a determination of medical necessity and the appropriateness of the level of care, continuing length of stay reviews, retrospective stay reviews and issues to provider authorizations for care that meets utilization management criteria.
Among the key duties of this position are the following:
Performs clinical reviews for entry into all levels of care based on a determination of medical necessity and the appropriateness of the level of care, continuing length of stay reviews, retrospective stay reviews and discharge follow up for all levels of care as evidenced by supervisory review.
Assesses and follows up on clients re-admitted within 30 days of discharge from care at all levels of care.
Monitors lengths of stay and length of stay norms to identify and monitor clients who need certification for continued stay, as assigned by Supervisor.
Identifies, monitors and documents problems in utilization review and provider relations and recommends to Supervisor and Director of Managed Care Services, for problem correction.
Communicates with utilization management team regarding client clinical information obtained during pre-certification for admission to care, concurrent continuing length of stay and retrospective reviews with providers of care.
Minimum Education and Experience:
Master's Degree in a mental health discipline or a related social science.
Must have an active, unencumbered license, as required by their New Jersey State Board of licensure.
Currently licensed in the state of New Jersey as a Licensed Clinical Alcohol and Drug Counselor (LCADC), or a Licensed Clinical Social Worker (LCSW), or a Licensed Professional Counselor (LPC), or a Licensed Marriage and Family Therapist (LMFT).
Applicants possessing a degree in Social Work must have an active New Jersey certification/licensure as required by the New Jersey Board of Social Work.
Required Knowledge, Skills, and Abilities:
Must possess a valid driver's license.
At least two (2) years of documented substance use disorder treatment experience.
Experience with Treatment Authorization procedures.
Experience conducting utilization review procedures in managed care and familiarity with ASAM criteria are desirable.
Posting Number: 20ST2111
Location: Piscataway (RBHS)
Internal Number: 122659
About Rutgers University
Rutgers, The State University of New Jersey, is a leading national public research university and the state's preeminent, comprehensive public institution of higher education. Rutgers is dedicated to teaching that meets the highest standards of excellence; to conducting research that breaks new ground; and to turning knowledge into solutions for local, national, and global communities. As it was at our founding in 1766, the heart of our mission is preparing students to become productive members of society and good citizens of the world. Rutgers teaches across the full educational spectrum: preschool to precollege; undergraduate to graduate and postdoctoral; and continuing education for professional and personal advancement. Rutgers is New Jersey's land-grant institution and one of the nation's foremost research universities, and as such, we educate, make discoveries, serve as an engine of economic growth, and generate ideas for improving people's lives.