Care Manager - BH

ICONMA; Canada; Remote; CAD 60,000 - 80,000; Full time

Job summary

An established industry player in healthcare is seeking a dedicated professional to monitor and improve mental health and substance abuse treatment services. This role involves providing crisis intervention, developing discharge plans, and ensuring quality of care through effective communication with providers and community resources. Ideal candidates will possess a relevant licensure and demonstrate strong organizational and problem-solving skills. Join a forward-thinking team committed to enhancing patient care and making a difference in the lives of individuals seeking support.

Qualifications

• Licensure required: CEAP, LMSW, LCSW, LPC, RN or LPN.
• Minimum experience in healthcare or behavioral health setting.

Responsibilities

• Monitor care services related to mental health and substance abuse.
• Develop discharge plans and oversee their implementation.
• Participate in quality improvement activities.

Skills

Organizational Skills

Time Management

Communication Skills

Utilization Management Knowledge

Problem-Solving

Education

CEAP Certification

LCSW License

LPC License

RN License

LPN License

Tools

Computer Systems

Job description

Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.

Provides telephone triage, crisis intervention, and emergency authorizations as assigned.

Performs concurrent reviews for inpatient and/or outpatient care and other levels of care as allowed by scope of practice and experience.

In conjunction with providers and facilities, develops discharge plans and oversees their implementation.

Performs quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatment.

Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria. Interacts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.

Participates in quality improvement activities, including data collection, tracking, and analysis.

Maintains an active workload in accordance with National Care Manager performance standards.

Works with community agencies as appropriate.

Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.

Participates in network development including identification and recruitment of quality providers as needed.

Advocates for the patient to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process.

Responsibilities:

Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements.

One or more of the following licensures is required for this role with necessary degrees:

CEAP, LMSW, LCSW, LPC, RN or LPN.

Minimum years’ experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse healthcare setting.

Strong organization, time management, and communication skills.

Knowledge of utilization management procedures, mental health and substance abuse community resources, and providers.

Knowledge and experience in inpatient and/or outpatient setting. Knowledge of DSM V or most current diagnostic edition.

Ability to analyze specific utilization problems, plan, and implement solutions that directly influence quality of care.

Work experience: Clinical + years

Certifications:

Must have one of the following:

CEAP - Certified Employee Assistance Professional, LCSW - Licensed Clinical Social Worker, LMFT - Licensed Marriage and Family Therapist, LMSW - Licensed Master Social Worker, LPC - Licensed Professional Counselor, LPN - Licensed Practical Nurse, RN - Registered Nurse, State and/or Compact State Licensure.

Required skills: Top must-haves:

Business management experience.

Computer knowledge.

Stable hard wired fast internet.

Private workspace that abides by HIPAA standards.

Nice-To-Haves:

Certification Requirements.

Must be Independently licensed in the State of California.

How many years of experience are you looking for: