Job summary
Job post source
This job is directly from NYC Health + Hospitals
Job overview
The BH UM Clinician role at NYC Health + Hospitals involves managing behavioral health utilization and quality management to ensure appropriate and cost-effective care for health plan members.
Responsibilities and impact
The clinician conducts telephonic reviews of inpatient and outpatient services, collaborates with providers and medical directors on care decisions, promotes alternative care options, participates in interdisciplinary care team meetings, evaluates housing needs, supports discharge planning, identifies high-risk cases for referral, and contributes to quality improvement and education efforts.
Experience and skills
Requires a Master's degree and at least 3 years of behavioral health experience in managed care utilization review or related fields, with preferred experience in psychiatric hospital settings, integrated care models, chronic condition management, and quality management. Licensure as LCSW, LMSW, or LMHC with a valid NY State license is mandatory.
Work environment and culture
The company values integrity, teamwork, customer service, and technical proficiency, fostering a collaborative and supportive environment focused on empowering communities through care.
Company information
MetroPlus Health, a subsidiary of NYC Health + Hospitals, provides comprehensive healthcare services across New York City and is part of the largest public health system in the US with over 27,000 providers.
Job location and travel
This is a fully remote, project-based position expected to last through April 2026 with possible extension.
Unique job features
The role involves using specialized tools like InterQual, LOCADTR, and CareConnect, and focuses on innovative care coordination and utilization management within a large public health system.
Company overview
NYC Health + Hospitals is the largest public health care system in the United States, providing essential medical services to over a million New Yorkers annually. They operate a network of 11 acute care hospitals, five nursing facilities, and numerous community health centers, ensuring comprehensive care regardless of patients' ability to pay. Established in 1969, the organization has a rich history of serving diverse communities and addressing public health challenges. Their revenue primarily comes from patient services, government funding, and various health programs, emphasizing their commitment to accessible and equitable healthcare.
How to land this job
Tailor your resume to highlight your experience in behavioral health utilization management, including telephonic review and use of InterQual, LOCADTR, and OMH Criteria Sets, emphasizing your ability to manage medical costs through prospective and concurrent reviews.
Showcase your skills in collaborating with health plan members and providers, particularly your experience in educating providers on alternative care options, medication compliance, and treatment programs like first episode psychosis and inpatient detox alternatives.
Apply through multiple platforms such as the NYC Health + Hospitals corporate careers page and LinkedIn to maximize your chances, ensuring your application is visible across key job boards.
Network by connecting on LinkedIn with clinicians and managers within the Behavioral Health Utilization Management division at NYC Health + Hospitals; start conversations by referencing recent MetroPlusHealth initiatives or asking about their experience with integrated care models.
Optimize your resume for ATS by incorporating keywords from the job description like 'behavioral health utilization management,' 'InterQual,' 'LOCADTR,' 'CareConnect,' 'quality assurance,' and 'discharge planning' to pass automated screenings effectively.
Use Jennie Johnson's Power Apply feature to automate tailored resume customization, multi-channel applications, and LinkedIn networking, freeing up your time to focus on interview preparation and skill enhancement.
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