Job: Clinical Specialist

Clinical Specialist

Salary: 
  • $58,000 - $66,000 per year. Compensation is commensurate with level of experience.
  • Eligible for a 1-time bonus after successful completion of training in 3-4 modules with demonstrated proficiency.
  • Eligible for salary increase after successfully trained and work knowledge acquired, generally 6-8 months after hire date.

Schedule: Regular schedule is Monday-Friday. Weekends and holidays are on an "on-call" rotating schedule. In office position with work from home (WFH) option once training completed; work performance and proficiency achieved.

Location: Tampa, FL and Work From Home 

About BHM

BHM Healthcare Solutions, Inc. is a dynamic healthcare company providing behavioral health and medical review services to health plans, health systems, hospitals, and other insurers nationally for over 18 years. Daily, we "live" our core values of:
  • Always improving
  • Client centric
  • Culture of excellence
  • Data driven decision making
  • Open, honest communications
By joining our team, you will become part of a collaborative and engaged team committed to achieving exemplary results. At BHM, we invest in training our employees and providing an opportunity to grow in your career. BHM is located conveniently in the Westshore area, right off Highway 275 and Veterans Highway.

Fundamentals of Clinical Specialist position:

  • Partakes in a structured, well-designed training program
  • Utilizes clinical experience, criteria/guidelines, and policies and procedures in support of ensuring timely and accurate medical necessity/benefit determinations
  • Analyzes information to support the process of rendering appropriate medical necessity and/or benefit determinations
  • Synthesizes clinical information and develops clinical review summaries
  • Utilizes clinical skills to support the documentation and communication of medical and behavioral health service determinations
  • Conducts quality Peer Reviewer audits for medical and behavioral health reviews
  • Acts as a liaison between Peer Reviewers and clients as well as a support for Peer Reviewers, including training and mentoring
  • Employs strong customer service skills, both verbally and written, and client understanding to ensure a premiere experience for client interactions
  • Performs well and thrives in a fast-paced team environment
  • Enjoys clinical administration type of work

Qualifications for Clinical Specialist:

  • Education
    • Associates degree required
    • Bachelor's degree preferred
  • Licensure
    • Active RN clinical license required
    • Active Florida Clinical License (BSN, RN, LCSW)
  • Experience
    • Minimum 6 months experience of direct patient care preferred
    • 1-2 years' experience processing clinical peer reviews for Utilization Management program preferred
    • Experience in Utilization Review or Health Plan review preferred
Competitive Benefits Include:
  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • Paid Time Off
  • 401K Match Program
Resumes may be submitted via this page by completing the form below or via email at candidates@bhmpc.com

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