Please note that schedule is Fridays, Saturdays, Sundays, and every other Thursday, 6:30PM-6:30AM CST.
Who We Are
At Lucet, we are industry leaders in behavioral health, dedicated to helping people live healthy, balanced lives. Our mission - and our passion -
is to improve the lives of the members we serve and be the ideal partner for our providers.
Lucet's unique combination of people and technology has proven to optimize access to behavioral health care providers and increase a health plan's ability to connect members to quality care. With the industry's largest network of care navigators and technology powered by more than six million assessments and more than 20 years of data, Lucet is the only solution proven to successfully identify and connect people across the entire acuity spectrum with the right care in less than five days on average, and often as little as one day.
Our members, providers and partners fully entrust us to deliver outstanding quality care through coordinated behavioral health services, employee assistance programs, organizational consulting, student well-being programs and more.
When you join Lucet, you become a valued member of our team, serving more than 15 million people across the U.S. Our employees have a passion for helping others - and it shows. From entry-level employees to senior leaders, we are inspired by our members, putting them first in everything we do. From day one, you'll see firsthand the impact you have on our members, knowing you can make a true difference in their lives.
Job Summary
The Clinician, C365 will be responsible for providing excellent clinical customer service by handling incoming telephone contacts from insured, EAP, uninsured callers, and providers. Depending on the nature of the call, the Clinician conducts clinical telephonic focused screenings, provides referrals to appropriate health care and community resources, conducts clinical precertification for appropriate level of care, promotes care transitions activities for members being discharged from higher levels of care, addresses routine inquiries, and strives to reduce obstacles to access to behavior health care. This is a remote position.
Essential Functions
- Demonstrates a professional knowledge of mental health diagnosis and treatment modalities in a managed care and/or EAP context.
- Demonstrates knowledge of the range of mental health and EAP benefits provided by member's insurance.
- Provides utilization review activities during established times for behavioral health care authorization requests with contacts to facilities and providers as needed to accomplish this task
- Demonstrates the ability to engage with members, families, providers; assess the callers needs; and provide education, resources, and navigation to promote access to behavior health services.
- Promotes and provides effective and quality service delivery for optimal member health outcomes
- Coordinates and/or completes peer review process on clinical cases that are not meeting the medical necessity criteria
- Provides clinical expertise in response to a variety of circumstances ranging from crisis intervention to routine business matters
- Utilizes appropriate and standardized tools including but not limited to Lucet approved precertification, physician review tools, authorization screen, and other application and tools
- Completes appropriate documentation in clinical systems in compliance with regulatory and accreditation standards
- Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and Lucet services, policies and procedures and criteria
- Coordinates consultations with member's provider, family and Lucet Physician consultants on clinical cases when necessary and appropriate to facilitate care and progress
- Stays current with Lucet's technology, member Behavioral Health benefits, and non-health community resources
- Provides follow-up and support calls to members and providers as needed and as assigned by Manager/Supervisor
- Works during holidays as scheduled unless paid time off arrangements are made with manager.
- Demonstrates the initiative, self-organizational skills, self-discipline, and competence to work remotely from a home office.
- Has a home based office that provides an environment conducive to completing assigned job responsibilities and meets the standards outlined under the Lucet telecommuting policy
- Is flexible and willing to provide assistance to co-workers when needed in urgent or routine situation Covers assigned hours/shifts and has the ability to cover other shifts as assigned by department director, manager, or designee and serves on the department clinical on-call rotation as mandatory
- Participates in on-going continuing education as required by professional licensure, certification, or as requested by Lucet and maintains required clinical licensure and certifications
- Participates in special committees or projects for program development as assigned by the Manager/Supervisor
- Attends on site staff meetings, required professional trainings, Lucet all staff meetings, after-hours staff meetings
- Participates in group peer process in which difficult cases are presented where interventions are validated as appropriate as well as suggestions for change and problem solving occurs
- Adheres to the policies and procedures for Utilization Management activities as well as screening, triage and referral activities, including timeliness of activities/services and accuracy of documentation
- Adheres to Professional Codes of Ethics as determined by professional licensure, certification and company policy
- Adheres to Lucet Mission Statement, Core Values, Code of Business Conduct and Compliance Program
- Complies with all Federal and applicable State laws and Lucet policies regarding privacy, confidentiality and security of health information and other designated information
Required
Job Qualifications
- A current, unrestricted license issued by a state or territory of the United States as a Clinical Social Worker, Marriage and Family Therapist, Professional Counselor, Clinical Psychologist or Registered Nurse.
- Minimum of 3-5 years of direct clinical care experience with patients in facility-based and/or outpatient psychiatric or chemical dependency treatment
- Strong clinical skills
- Excellent verbal and written communication and interpersonal skills
- Strong computer and keyboarding skills (Microsoft Outlook and Word), including the ability to document while simultaneously while taking information over the phone
Preferred
- Minimum of five (5) years post-licensure experience in direct clinical care with patients in facility-based and/or outpatient psychiatric or chemical dependence treatment
- For Registered Nurses, a Bachelor's Degree in Nursing
- Previous EAP experience, CEAP certification
- Minimum of two (2) years' experience in a managed care environment.
- Minimum of two (2) years' experience in crisis intervention work, in-service and professional training experience
- Previous experience in Utilization Review
- Experience and training in Motivational Interviewing
Key Competencies
- Self-motivated and the ability to assume a role in ensuring that all objectives are met
- Ability to work independently to complete work assignments and team objectives/goals
- Maintains curiosity and an eagerness to explore new knowledge and try new ideas and approaches
- Excellent communication and interpersonal skills
- Professional demeanor in response to all situations regardless of the nature or circumstances of the situation
- Able to manage multiple tasks in a fast-paced, changing environment
- Ability to work within a collaborative, team-oriented environment
- Ability to work efficiently and effectively in a remote environment with other remote team members and a remote supervisor
Working
Conditions
- Work is performed indoors in a remote, home setting or typical office environment- not substantially exposed to adverse environmental conditions.
- Frequent exposure to VDT screen.
- Frequent use of office machines to include telephone, copier, computer, and fax machine.
- Must be able to constantly remain in a stationary position, communicate and exchange information with others, inspect information, perform repetitive motions with arms and fingers, interpret data, problem solve, make decisions, organize and plan, and maintain a positive and professional attitude in all situations.
Salary And Other Compensation
The starting salary that Lucet reasonably expects to pay for this position ranges from $60,000 - $75,000 annually, depending on circumstances including an applicant's skills, education/degrees, certifications, prior experience, market data, and other relevant factors.
This position is eligible for a bonus in accordance with the terms of Lucet's incentive plan based on both company performance and individual performance.
Benefits: The Company offers the following benefits for this position, subject to applicable eligibility requirements: Medical, Dental, Vision, 401(k) with competitive employer match, company paid life and disability insurance, company paid gym access, tuition reimbursement, parental leave, PTO (vacation, sick and volunteering), Remote Work.
Requirements
This position is a federally contracted position with the United States Postal Service. which has specific requirements for all candidates which include:
- The ability to pass a 10-panel drug screen prior to their date of hire.
- The ability to undergo a Public Trust background investigation and receive a favorable adjudication.
- US Citizenship for at least 5 years.
This position will accept and review new applications and resumes no less than 5 business days after the original posting date and may remain open an extended period of time with no set end date based on the level of interest. 
