Remote Reauthorizations Manager

HealthRIGHT 360 gives hope, builds health, and changes lives for people in need by providing comprehensive, integrated, compassionate care that includes primary medical care, mental health services, and substance use disorder treatment.

Benefits and perks:

• HR360 offers a robust benefits package, including PTO, 15 paid holidays, commuter benefits, retirement plans, and more!
• Employees qualify for public loan forgiveness programs
• Training and professional development opportunities
• Work with mission driven, compassionate colleagues and make a difference every day in the work that you do.

JOB SUMMARY 

The Remote Reauthorizations Manager functions as the liaison between Intake services and other internal agency components as well as outside entities.

This is a fully remote position.

Primary responsibilities include:

• Contributing to the creation/changes of the clinical workflow for authorizations team
• Tracking authorization end dates and reauthorization request due dates for the team
• Chairing and creating the agenda for the weekly reauthorization team meeting  and the weekly meetings between the reauthorization team and the residential program staff
• Leading communication and weekly meetings with the county authorization department to improve authorization approval rates
• Ensuring minimal authorization gaps and coordinating with the billing department
• Providing administrative and clinical supervision and oversite of LPHA authorizations staff Coordinating care with residential programs’ leadership and treatment teams as well as the medical team, including psychiatry and MAT services as needed.
• Ensures that clients meet criteria for admission and continued treatment at our various programs and ensures medical necessity is justified.
• Conducts client assessments to determine continued need for care and documents findings of assessment to be submitted for re-authorization based on continued medical necessity.
• Will review assessments conducted by clinical staff, provide feedback, consult on denials and resubmissions, and sign off as LPHA when needed

QUALIFICATIONS

Education and Experience

Required:

• California licensure as a Psychologist, LMFT, LCSW, or LPCC
• 2 years post licensure and able to provide clinical supervision
• Experience with Welligent/AVATAR and other EMR systems
• Experience with Mental Health Medi-Cal procedures
• Familiar with Drug-medical organized delivery system
• Minimum two years of experience in dual diagnosis substance abuse treatment in an inpatient or outpatient community mental health setting
• Supervision experience in mental health or psychiatric setting with varied populations
• Demonstrated clinical paperwork and record keeping abilities
• Familiarity with trauma informed therapy models, cognitive–behavioral therapy, brief psychotherapy, ASAM assessment, and psycho-educational approaches.
• Familiarity with working with psychotic and other severe mental health presentations
• Ability to work as part of an interdisciplinary team
• Clinical experience in performing risk assessment and crisis intervention