Skip to content
CV Rocket
Get started
How it worksThe enginePricingBlogContactSign in

Open nowPosted today

Clinical Care Reviewer II - Behavioral Health

CareSource124 open roles

Pay
$75,200 – $120,500 a year
Where
Massachusetts WFH
Work mode
Remote
Get the CV for this job

From $25 per CV, paid once. No subscription.

Your applicationOpen nowClinical Care Reviewer II - Behavioral HealthCareSource · Massachusetts WFH

  1. YouYes, apply to this one.

  2. CV RocketCV written for this posting.

  3. 25 readersRecruiter, hiring manager, skeptic. Round after round.

  4. CV RocketApplied on CareSource's own form.

The reply lands in your private mailbox

3×more interviews than doing it yourself with ChatGPT.

The clock on this job

Early applications get read.

13.8% of postings close within 7 days. Measured by our own scanner across the market. CareSource postings stay open a median of 13 days.

Share of postings closed within
  1. 2.2%1 day
  2. 4.7%3 days
  3. 13.8%7 days
  4. 22.3%14 days
  5. 37.8%30 days
  6. 59.0%60 days
This job: posted today

CareSource median: 13 days open

The posting

Job Summary:

Clinical Care Reviewer II – Behavioral Health is responsible for processing medical necessity reviews for appropriateness of authorization for behavioral health care services, assisting with discharge planning activities (i.e. outpatient services, home health services) and care coordination for members.

Essential Functions:

  • Complete prospective, concurrent and retrospective review of Behavioral Health services
  • Identify, document, communication and coordinate care engaging collaborative care partners to facilitation transition to an appropriate level of care
  • Engage with medical director when additional clinical expertise if needed
  • Maintain knowledge of state and federal regulations, including State Contracts and Provider Agreements, benefits, and accreditation standards
  • Identify and refer quality issues to Quality Improvement
  • Identify and refer appropriate members for Care Management
  • Provide guidance to non-clinical staff
  • Provide guidance and support to LPN staff
  • Attend medical advisement and State Hearing meetings, as requested
  • Assist Team Leader with special projects or research, as requested
  • Perform any other job related duties as requested.

Education and Experience:

  • Associates of Science (A.S) in Nursing required or
  • Bachelor of Science (B.S) in Social Work required or
  • Master's degree in a mental health related field (Psychology, Counseling Psychology, Marriage or Family Therapy) required
  • Three (3) years clinical experience required
  • Utilization Management/Utilization Review experience preferred
  • Medicaid/Medicare/Commercial experience preferred

Competencies, Knowledge and Skills:

  • Proficient data entry skills and ability to navigate clinical platforms successfully
  • Working knowledge of Microsoft Outlook, Word, and Excel
  • Effective oral and written communication skills
  • Ability to work independently and within a team environment
  • Attention to detail
  • Proper grammar usage and phone etiquette
  • Time management and prioritization skills
  • Customer service oriented
  • Decision making/problem solving skills
  • Strong organizational skills
  • Change resiliency

Licensure and Certification:

  • Current, unrestricted Registered Nurse (RN) Licensure, Licensed Social Worker (LSW, Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LICSW), Associate Clinical Social Worker (ACSW), Licensed Mental Health Counselor (LMHC), Licensed Professional Counselor (LPC), Licensed Marriage & Family Therapist (LMFT) or Licensed Mental Health Practitioner (LMHP) required
  • MCG Certification is required or must be obtained within six (6) months of hire required

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time
  • Travel is not typically required

Compensation Range:

$75,200.00 - $120,500.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Hourly

Organization Level Competencies

  • Fostering a Collaborative Workplace Culture
  • Cultivate Partnerships
  • Develop Self and Others
  • Drive Execution
  • Influence Others
  • Pursue Personal Excellence
  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

#LI-JS2

Brand=Commonwealth Care Alliance

From $25, paid onceGet the CV for this job

What happens when you press

One press. We do the rest.

  1. A CV for this posting

    Written against CareSource's own wording, from every piece of relevant proof in your profile.

  2. 25 readers review it

    Recruiter, hiring manager, skeptic and more read every draft, round after round. You get the best round.

    The review screen in CV Rocket: how each CV was read, round by round.

  3. We apply on CareSource's form

    Our application engine gets through the hardest forms there are. Where a question needs you, AI suggests the best answer. Don't want us applying from our IP addresses? Use our Chrome extension: we apply straight from your own browser.

    An application in CV Rocket: every answer filled in on the employer's form.

  4. Every reply, sorted

    CareSource's answer lands in your private mailbox, and we classify it on arrival: interview, question, rejection.

    The CV Rocket inbox: each employer reply classified as an interview, an action or a rejection.

  5. Reply with AI

    AI helps you write the email, checks it and sends it. We show you whether the recruiter read it.

  6. The interview in your calendar

    Full integration with your calendar. The invitation goes straight in.

    An interview invitation in the CV Rocket inbox, added to the candidate's calendar.
Get the CV for this job

From $25 per CV, paid once. No subscription.

Why it works

3×

more interviews than doing it yourself with ChatGPT.

ChatGPT writes a CV and never learns what happened to it. We see every reply. For each CV we know:

  • How it was written, and how the review scored it
  • When we applied, and how long after the posting went up
  • Which posting, which company, which city
  • Who got the interview, and who heard nothing

That is how we know which CVs get called.

Get the CV for this job

From $25 per CV, paid once. No subscription.

The numbers game

More applications. More interviews.

Every application goes out with its own CV, written for that posting and paid once. Send enough of them and the law of large numbers finds you the job.

Get the CV for this job
By hand5–10
With CV Rocket100
applications a day

Nearby

Live postings like this one

Same employer first, then the same role elsewhere.

Before you press

Straight answers

Get the CV for this job

From $25 per CV, paid once. No subscription.

What if my background isn't good enough?

We make the most of the background you have. The CV uses every piece of relevant proof your profile holds, and one of the 25 readers reads your whole profile and flags what the CV left out.

Do you really apply for me?

Yes, on the employer's own form, the hardest ones included. Where a question needs you, you answer it right there and AI suggests the best answer. Don't want us applying from our IP addresses? Use our Chrome extension: we apply straight from your own browser.

Is it a subscription?

No. You pay once per CV, from $25. Every application goes out with its own CV, written for that posting.

One job. One CV.
Paid once.

Pick the posting you want. We write for it, apply for you and catch the reply.

Get the CV for this job

From $25 per CV, paid once. No subscription.