Arizona Complete Health
Authorize and/or review utilization of mental health and substance abuse services provided in inpatient and intermediate care settings. Assure appropriate levels of care and medical necessity in a manner that supports the recovery process
Identify placement settings that offer the lowest level of restriction and greatest level of autonomy for the members based upon medical necessity
Monitor quality of
care and collect and analyze utilization data
Serve as a resource
and liaison between the health plan, behavioral providers, facilities, member
and families
Provide and/or
review member intakes and initial evaluations
Comply with
performance measures in regards to denials, higher level of care admission
certifications and concurrent review timeliness
Develop and
maintain collaborative relationships with providers and educate on levels of
care
Interact with
physicians, social workers, providers, case managers, and family members to
develop discharge plans and oversee their implementation
Qualifications:
Education/Experience: Bachelor’s degree in related field or equivalent experience.