Behavioral Health Job at MVP Health Care
Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds—tech people, numbers people, even people people—working together to make health insurance better. Our clinical staff works with doctors, hospitals, pharmacies, and other health care professionals are dedicated to improving the delivery of health care: with better communication, better sharing of information, and ultimately, better results for our members. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference—it’s time to make a healthy career move to MVP!
There are some positions at MVP where your work may require an onsite or community component. When working in an MVP office and/or in the community on behalf of MVP, you must be fully vaccinated against COVID-19, and have received the first booster dose within one month of eligibility.
Professional, Behavioral Health Job Summary
This position makes triage and referral decisions requiring clinical judgement, with an emphasis placed on Autism Spectrum Disorders (ASD). The individual will primarily be responsible for assessing clinical appropriateness and medical necessity of Applied Behavior Analysis (ABA). Other responsibilities will include following customers for mental health, substance use and co-morbid medical disorders according to the benefit guidelines and policies across the continuum of care. The individual will review all requests for inpatient services in view of the Appropriate BH and MVP standards, such as InterQual and LOCADTR guidelines as well as MVP Medical Policies, assuring that appropriate follow up of outpatient services occur. The position will provide case management/ care coordination for members to assess, plan, implement, coordinate, monitor, and evaluate options and services required to meet an individual’s behavioral health needs. The individual will review requests for all outpatient care plans for both mental health or substance services, using MVP’s Utilization Management programs for entering and tracking cases, correspondence, and documentation. In addition, the individual will conduct retrospective review of inpatient/outpatient cases and reviews as needed, with supervisors or medical directors. Individuals will share after hours and weekend on-call responsibilities. Site visits to providers or to facilities to attend team meetings to assist in developing relationships and safe, effective alternative service settings may be required. Performs other duties and special projects as assigned.
POSITION QUALIFICATIONS
Minimum Education:
Minimum Experience:
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com
Please apply and learn more – including how you may become a proud member of our team.
Please Note :
apexdining.ca is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, apexdining.ca provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.
There are some positions at MVP where your work may require an onsite or community component. When working in an MVP office and/or in the community on behalf of MVP, you must be fully vaccinated against COVID-19, and have received the first booster dose within one month of eligibility.
Professional, Behavioral Health Job Summary
This position makes triage and referral decisions requiring clinical judgement, with an emphasis placed on Autism Spectrum Disorders (ASD). The individual will primarily be responsible for assessing clinical appropriateness and medical necessity of Applied Behavior Analysis (ABA). Other responsibilities will include following customers for mental health, substance use and co-morbid medical disorders according to the benefit guidelines and policies across the continuum of care. The individual will review all requests for inpatient services in view of the Appropriate BH and MVP standards, such as InterQual and LOCADTR guidelines as well as MVP Medical Policies, assuring that appropriate follow up of outpatient services occur. The position will provide case management/ care coordination for members to assess, plan, implement, coordinate, monitor, and evaluate options and services required to meet an individual’s behavioral health needs. The individual will review requests for all outpatient care plans for both mental health or substance services, using MVP’s Utilization Management programs for entering and tracking cases, correspondence, and documentation. In addition, the individual will conduct retrospective review of inpatient/outpatient cases and reviews as needed, with supervisors or medical directors. Individuals will share after hours and weekend on-call responsibilities. Site visits to providers or to facilities to attend team meetings to assist in developing relationships and safe, effective alternative service settings may be required. Performs other duties and special projects as assigned.
POSITION QUALIFICATIONS
Minimum Education:
- Master’s prepared mental health clinician (LMSW, LCSW, LMHC, etc.), or licensed Registered Nurse (RN).
- Licensed Behavior Analyst (LBA) or Board-Certified Behavior Analyst (BCBA) preferred, but not required.
Minimum Experience:
- Minimum of 3 years of direct clinical practice (mental health and/or substance use) with children and/or adolescents required, with at least 2 years being ASD related.
- UM or Case Management experience in a managed care organization is preferred.
- Knowledgeable with diagnosis and procedural coding, InterQual and ASAM guidelines, psychiatric medication management, hospital case management, and related mental health and substance use treatment.
- Required Skills:
- Capable of independent thinking with excellent problem-solving skills.
- Strong interpersonal, communication and computer skills with the ability to work in a team setting.
- Detail oriented with strong organizational skills including the ability to manage time wisely to meet established deadlines.
- Experience with situations requiring strict adherence to confidentiality.
- Ability to solve problems while exhibiting clinical judgment and realistic understanding of the current environment.
- Ability to make independent decisions regarding resource utilization, and quality of care.
- Must demonstrate understanding of clinical and psychosocial issues that may alter treatment or care plan and be able to demonstrate good judgment when dealing with emotionally charged situations.
- Strong computer skills including working knowledge of Word, Windows based applications, typing and internet access.
About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com
Please apply and learn more – including how you may become a proud member of our team.
Please Note :
apexdining.ca is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, apexdining.ca provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.