This position focuses on gathering demographic and clinical information to approve and direct consumers to needed behavioral health or substance use services. The role supports individuals by offering guidance, documentation, and coordination throughout the care process. As a Clinical Care Reviewer, you will perform the following duties:
- Information Gathering: Collect demographic and clinical details by telephone to support service authorization
- Service Guidance: Provide consumers with information on benefits, treatment options, and community resources
- Case Evaluation: Review and assess the medical appropriateness of psychiatric and substance use cases
- Advocacy Support: Act as an advocate for consumers and families while coordinating with other care managers
- Documentation Standards: Maintain accurate records and complete referral documentation in line with program requirements
- Follow Up: Conduct follow up with consumers and service providers to ensure ongoing support
Work Schedule and Additional Information:
Full-time employment
Work hours are 8:30 AM to 4:30 PM, Monday - Friday, with a 30-minute lunch.
Telework: You will not have the option to telework in this position.
Salary: In some cases, the starting salary may be non-negotiable.
You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.
QUALIFICATIONS
Minimum Experience and Training Requirements:
A master's degree in social work, psychology, nursing, or counseling and two years of professional mental health clinical experience; or
Two years of professional mental health clinical experience and possession of an active license to practice as a Registered Nurse issued by the Pennsylvania State Board of Nursing.
Special Requirements:
- This position requires an active license issued by the Pennsylvania Bureau of Professional and Occupational Affairs in one of the following areas:
- Social Work
- 20001-Social Worker
- 20010-Clinical Social Worker
- 20020-Marriage and Family Therapist
- 20030-Professional Counselor
- 20001-Social Worker
- Psychology
- 26001-Psychologist
- 26001-Psychologist
- Nursing
- 18001-Registered Nurse
- 18040-Certified Registered Nurse Practitioner
- 18170-Clinical Nurse Specialist
- 18001-Registered Nurse
- Social Work
Other Requirements:
You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency Guidelines.
You must be able to perform essential job functions.
Legal Requirements:
This position falls under the provisions of the Child Protective Services Law.
Under the Law, a conditional offer of employment will require submission and approval of satisfactory criminal history reports including, but not limited to, PA State Police clearance, PA Child Abuse history clearance, and FBI Fingerprint clearance.
How to Apply:
Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education).
If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.
Your application must be submitted by the posting closing date. Late applications and other required materials will not be accepted.
Failure to comply with the above application requirements may eliminate you from consideration for this position.
All application materials and interview responses must reflect the applicant’s own experience, qualifications, and work. Applicants may use generative AI tools for preparation purposes only. Use of AI to misrepresent or falsify information, or to assist during interviews, is not permitted. Review the Guidance for Generative AI Tools & Job Seekers for additional information.
Veterans:
Pennsylvania law (51 Pa. C.S. §7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to www.pa.gov/agencies/employment/how-to-apply.html and click on Veterans.
Telecommunications Relay Service (TRS):
711 (hearing and speech disabilities or other individuals).
If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.
The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.
- Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam).
- Your score is based on the detailed information you provide on your application and in response to the supplemental questions.
- Your score is valid for this specific posting only.
- You must provide complete and accurate information or:
- your score may be lower than deserved.
- you may be disqualified.
- You may only apply/test once for this posting.
- Your results will be provided via email.