Utilization Review Clinician-BHC

Tallahassee Memorial Healthcare (TMH) is a private nonprofit community-based healthcare system that provides care to a 22-county region in North Florida and South Georgia. We are a career destination with over 6000 colleagues who reflect the diversity of our community.

TMH is the regions healthcare leader and top provider of advanced care with a 772-bed acute care hospital and the regions only:

• Level II Trauma Center
• Primary Stroke Center
• Level III Neonatal Intensive Care
• Pediatric Intensive Care
• The most advanced cancer heart and vascular orthopedic & surgery programs in the Panhandle.

Our system also includes a psychiatric hospital multiple specialty care centers six residency programs and more than 50 affiliated physician practices.

Your Role:

• Conducts ongoing pre-certification concurrent and retrospective reviews on the Tallahassee Memorial Behavioral Health Center (TMBHC) inpatient population.
• Coordinates reviews with the respective insurance companies for which the medical necessity for initial admission certifications and continued stays are determined.
• Liaises between the Business Office insurance companies and attending psychiatrists.

Reports To:Director/BHC Operations (JC: 015601)

Supervises:None.

Required Education:

• Bachelors degree in a field of nursing counseling social work psychology or a related human services field

Preferred Education:

• Current enrollment in a masters degree program or masters degree in a mental health specialty (e.g. Master of Social Work Masters of Mental Health Master of Mental Health Counseling or Masters of Marriage and Family Therapy).

Required Experience:

• Two (2) years of relevant job-related experience

Preferred Experience:

• Two (2) to five (5) years of relevant job-related experience

Required Certification/License/Registry:

• None

Preferred Certification/License/Registry:

• Licensed as a registered nurse (RN) in accordance with Florida Statutes (F.S.) Title XXXII (Regulation of Professions and Occupations) Chapter 464 (Nursing) Part I (Nurse Practice Act) includes multistate compact licensure or licensed as a mental health professional (e.g. Licensed Clinical Social Worker (LCSW) Licensed Mental Health Counselor (LMHC) or Licensed Marriage and Family Therapist (LMFT)) in accordance with F.S. Title XXXII Chapter 491 (Clinical Counseling and Psychotherapy Services)

Tallahassee Memorial HealthCare is an equal opportunity employer and drug-free workplace. All employment is contingent upon successful completion of a drug screen background check reference verification health assessment and credential/license verification.