<p>Discover. Achieve. Succeed. #BeHere</p> <p>Location: US:WI:MENOMONEE FALLS at our FROEDTERT MEN FALLS HOSPITAL facility.</p> <p>This job is ON - SITE.</p> <p>FTE: 0.600000</p> <p>Standard Hours: 24.00</p> <p>Shift: 1</p> <p>Shift Details: Monday/Wednesday/Friday 8am-4:30pm, no holidays or weekends</p> <p>Job Summary:</p> <p>The Psychotherapist- Behavioral Health Utilization Review is a member of the Behavioral Health team who is responsible for establishing and documenting medical necessity for recommended patient services, supporting patients in accessing care, and acts as department liaison with revenue stakeholders. This is accomplished by working closely with all team members during patient's flow through the department including referral and work que management, clinical pre-screenings, verifying patients benefits, registrations and scheduling, and submitting behavioral health prior authorizations, clinical concurrent reviews, and discharge clinicals. Works closely with patient financial services, billing, pre-registration, managed care, and credentialing and manages department's insurance related denials and appeals. The position includes involvement in department QA activities. Supports direct clinic care roles across the department as needed and as directed by leader working as a psychotherapist within the department.</p> <p>EXPERIENCE DESCRIPTION:</p> <p>3,000 hours of post graduate clinical supervision, care coordination for behavioral health patients. Prior knowledge/experience with behavioral health hospital billing/pre-authorization or insurance verification with demonstrated knowledge of health insurance plans including: Medicare, Medicaid, HMO's and PPO's is preferred.</p> <p>EDUCATION DESCRIPTION:</p> <p>Master's degree in social work, counseling, educational psychology, or allied health profession from an accredited college or university is required. Masters degree in clinical mental or behavioral health discipline with clinic field placement/practicum is preferred.</p> <p>TRAINING DESCRIPTION:</p> <p>Specific clinical training in psychotherapy, psychiatric evaluation and assessment is required. Treatment for substance use disorders, training in one or more specific modality of treatment (CBT, DBT, ACT etc.) is preferred.</p> <p>SPECIAL SKILLS DESCRIPTION:</p> <p>Understanding of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM). Exceptional customer relations skills. Knowledge on American Society of Addiction Medicine (ASAM) levels of care criteria and Behavioral Health billing/coding is preferred. Knowledge of online insurance eligibility systems, preferred. Excellent typing and computer skills is preferred. Familiarity with Medical Terminology, preferred. Demonstrated ability to efficiently organize work and maintain a high level of accuracy and productivity is preferred.</p> <p>LICENSURE DESCRIPTION:</p> <p>Current Wisconsin licensure as Licensed Clinical Social Worker (LCSW) or Licensed Professional Counselor (LPC). Substance Counselor (CSAC, SAC) certification is preferred.</p> <p>Perks & Benefits at Froedtert Health</p> <p>Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:</p> <ul> <li>Paid time off </li><li>Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities </li><li>Academic Partnership with the Medical College of Wisconsin </li><li>Referral bonuses </li><li>Retirement plan - 403b </li><li>Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics </li><li>Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available </li></ul> <p>The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.</p> <p>We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.</p>