Job: Care Management Coordinator

Implements the CPSA Care Management program in multiple environments, including prior authorization, concurrent review, retrospective review and care management of members identified as high-risk, high utilizing or outliers of services.

Monitors, evaluates and improves the utilization of behavioral health services and ensures continuity of care and integration of services for members across providers and with other agencies involved in the member’s care plan, including:
-discharge planning
-outreach and engagement activities, and
-timely access to services provided according to best practice.

Coordinates and communicates with other systems, Networks, providers to ensure member needs are met through the care management process. Adheres to federal and state utilization management regulations.

Master's degree in a behavioral health field and current licensure as a behavioral health professional by the State of Arizona Board of Behavioral Health Examiners plus five years experience in behavioral health services and one year minimum in hospital based utilization review; OR,

Current Arizona RN license and one year experience in behavioral health services and one year minimum in hospital based utilization review.