About careerzynith
careerzynith is a leading, innovative healthcare organization dedicated to transforming the lives of individuals and families through compassionate, evidence‑based services. With a national footprint and a commitment to excellence, careerzynith blends cutting‑edge technology, rigorous clinical standards, and a member‑first philosophy to deliver superior behavioral health care. Our mission is to ensure that every eligible member receives the highest quality of care, grounded in medical necessity and tailored to their unique needs. As a remote‑first employer, careerzynith empowers its workforce with flexibility, autonomy, and a collaborative culture that thrives on diversity, inclusion, and continuous learning.
Position Overview
careerzynith is seeking a highly motivated and experienced Remote Behavioral Health Care Manager to join our dynamic team. In this pivotal role, you will oversee and evaluate Behavioral Health Treatment (BHT) services, including Applied Behavior Analysis (ABA), for eligible members across the United States. You will act as a clinical gatekeeper, ensuring that all services meet stringent medical necessity criteria, comply with coding standards, and align with federal, state, and local regulations. This position is 100% remote, offering you the flexibility to work from any location while contributing to a mission‑driven organization that values integrity, accountability, and member satisfaction.
Key Responsibilities
Clinical Review & Authorization
- Conduct comprehensive reviews of ABA and other BHT service requests, assessing medical appropriateness against established clinical guidelines.
- Gather and verify pertinent medical documentation, ensuring completeness before submission to the Medical Director.
- Document all findings, decisions, and authorizations accurately within careerzynith’s utilization management system.
- Maintain rigorous compliance with ICD‑10, CPT‑4, and HCPCS coding standards, as well as coverage policies.
- Communicate authorization outcomes promptly to providers, members, and internal stakeholders, providing clear rationale and next steps.
Quality Assurance & Regulatory Compliance
- Stay current on evolving federal, state, and local regulations that impact BHT benefits, ensuring careerzynith’s processes remain compliant.
- Identify potential quality concerns, flagging trends or outliers for further investigation.
- Participate in case audits, supporting internal and external quality reviews.
- Develop and refine standard operating procedures to enhance efficiency and accuracy in utilization management.
Collaboration & Teamwork
- Partner with interdisciplinary teams—including clinicians, case managers, and compliance officers—to achieve departmental and organizational goals.
- Foster strong relationships with external partners, such as providers, agencies, and advocacy groups, to facilitate seamless care coordination.
- Contribute to cross‑functional projects, sharing insights that drive continuous improvement across careerzynith.
Member & Provider Communication
- Provide empathetic, clear, and timely communication to members regarding service approvals, denials, or required documentation.
- Educate providers on careerzynith’s authorization processes, coding requirements, and best practices for documentation.
- Serve as a trusted point of contact for escalated inquiries, resolving complex issues with professionalism and care.
Essential Qualifications
- Education: Master’s degree in psychology, social work, counseling, or a closely related field.
- Licensure: Current, unrestricted California license (LCSW, LPCC, LMFT, RN with behavioral health experience, BCBA, or BCBA‑D).
- Experience: Minimum of four (4) years delivering ABA or mental health services, including clinical review, treatment plan oversight, and utilization management.
- Technical Proficiency: Demonstrated expertise with Microsoft Office Suite (Word, Outlook, Excel, PowerPoint) and familiarity with electronic health record (EHR) or utilization management platforms.
- Regulatory Knowledge: Strong understanding of Medicaid/Medicare regulations, HIPAA compliance, and state‑specific behavioral health statutes.
Preferred Qualifications & Additional Skills
- Certification as a Board‑Certified Behavior Analyst (BCBA) or equivalent.
- Experience with telehealth platforms and remote case management tools.
- Advanced analytical abilities, including data interpretation and trend analysis.
- Project management experience, with a track record of leading process‑improvement initiatives.
- Exceptional written and verbal communication skills, with the ability to convey complex clinical information in an accessible manner.
- Demonstrated ability to work independently, prioritize competing demands, and meet tight deadlines in a fast‑paced environment.
Core Competencies for Success
- Integrity & Accountability: Uphold the highest ethical standards, taking ownership of decisions and outcomes.
- Collaboration: Build and sustain productive relationships with diverse internal and external stakeholders.
- Analytical Thinking: Apply critical thinking to assess clinical data, identify gaps, and recommend actionable solutions.
- Adaptability: Thrive in a remote setting, adjusting to flexible schedules that may include evenings or weekends as needed.
- Leadership: Inspire peers and cross‑functional teams, fostering a culture of continuous improvement and shared success.
Career Growth & Development Opportunities
careerzynith is committed to investing in the professional growth of its employees. As a Remote Behavioral Health Care Manager, you will have access to a robust learning ecosystem that includes:
- Mentorship programs pairing you with senior clinical leaders.
- Continuing education stipends for certifications, conferences, and advanced training.
- Opportunities to transition into senior management, clinical operations, or specialized consulting roles within careerzynith.
- Cross‑departmental projects that broaden your expertise in health policy, data analytics, and digital health innovation.
Work Environment & Culture at careerzynith
Our remote‑first culture is built on trust, flexibility, and a shared commitment to member well‑being. careerzynith promotes:
- A collaborative virtual workspace with regular team huddles, video conferences, and social events.
- Inclusive policies that celebrate diversity of thought, background, and experience.
- Wellness initiatives, including mental‑health resources, virtual fitness classes, and ergonomic support for home offices.
- A transparent leadership approach, where strategic goals and performance metrics are openly shared.
Compensation, Perks & Benefits
careerzynith offers a competitive total rewards package designed to attract and retain top talent:
- Salary: Competitive base pay commensurate with experience and expertise.
- Health Coverage: Comprehensive medical, dental, and vision plans with low employee contributions.
- Retirement Savings: 401(k) plan with generous company matching.
- Paid Time Off: Generous vacation, sick leave, and paid holidays to support work‑life balance.
- Professional Development: Tuition reimbursement, certification bonuses, and access to an online learning portal.
- Technology Stipend: Home office equipment allowance and high‑speed internet reimbursement.
- Employee Assistance Program: Confidential counseling and support services for you and your family.
How to Apply
If you are passionate about delivering high‑quality behavioral health services, thrive in a remote environment, and are eager to make a meaningful impact on members’ lives, we invite you to join careerzynith. Submit your resume and a compelling cover letter outlining your relevant experience, licensure, and why you are the ideal fit for this role.
careerzynith is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
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