Clinical Assessor (Remote - LPEI, LPC, LMSW, LCSW, LAC, LPE)

Clinical Assessor (Remote)

Who we need:

A Behavioral Health clinician to function as an Independent Assessor to evaluate documentation, administer the CANS and complete utilization review services. Work with a multi-disciplinary team to render determination and completion of the authorization process.

Why us?

Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting.

People Focused. Mission Driven.

Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise.

We do this through our people.

At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees and we provide the training and support to do the best work of your career.

Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more.

What you’ll do:

• Conducts member and/or provider assessments, audits, training and consultation to assure plans and interventions are appropriate. As appropriate, monitors and evaluates the services and community based resources necessary to respond to the individual member’s health needs.
• Uses independent judgment, clinical knowledge/competence, communication skills, problem solving and conflict resolution to ensure optimal member, provider and client outcomes with consideration to payor requirements.
• Ensures day-to-day processes are conducted in accordance with NCQA, URAC and other regulatory standards.
• Seeks consultation from physicians, clinical and other disciplines and departments as required to ensure appropriate care is being rendered.
• Ongoing reassessment of processes to offer opportunity for improvement and/or change.
• Foster positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building in order to facilitate the review process.
• Responsible for attending training and scheduled meetings and for maintenance and use of current/updated information for review.
• Maintains medical records confidentiality at all times through proper use of computer passwords, maintenance of secured files, adherence to HIPAA polices.
• Utilizes proper telephone etiquette and judicious use of other verbal and written communications, following KEPRO policies, procedures and guidelines
• Cross-trains to perform duties of other contracts within the KEPRO network to provide a flexible workforce to meet client/consumer needs.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

What you’ll need:

Required Qualifications

• Master’s level licensed behavioral health clinician (LPEI, LPC, LMSW, LAC, LPE).

Knowledge, Skills, Abilities

• Knowledge of NCQA/URAC standards strongly preferred.
• Knowledge of the organization of medical records, medical terminology, and disease process required.
• Strong clinical/social assessment and critical thinking skills required.
• Excellent verbal and written communication skills required.
• Ability to use independent judgment and discretion to address, resolve and process problems impeding the service needs.
• Proactively identify and resolves delays and obstacles.
• Ability to work in a team environment.
• Flexibility and strong organizational skills needed.
• Must be proficient in MS Office, Internet/Web Navigation.
• Must have high-speed (no dial-up) internet at home.
• Must be willing to travel and have active, unrestricted license, reliable transportation and active auto insurance.
• Must have an OSHA complaint home workspace committed to confidentiality of PHI.

Experience

• 5 years of experience assessing and trea