Care Manager

Integrated Resources Inc.; Orange (CA); On-site; USD 70,000 - 100,000; Full time

Job summary

Une entreprise dédiée à la santé mentale recherche un Clinical Reviewer pour rejoindre son équipe dynamique à Orange, Californie. Le candidat sera chargé de superviser les services d'hospitalisation et d'évaluer les traitements pour assurer leur conformité aux critères médicaux. Ce rôle est crucial pour garantir que les besoins des patients sont satisfaits de manière professionnelle et respectueuse.

Qualifications

• Licence LCSW, LMFT ou RN, exigée.
• Heures flexibles entre 8h et 20h, besoin d'une flexibilité pour les changements.
• Formation de 2 à 3 semaines nécessaire.

Responsibilities

• Surveille les services de traitement psychiatrique et fournit des revues concurrentes.
• Développe des plans de sortie en collaboration avec des prestataires.
• Intervient lors de crises et effectue des évaluations pour assurer l'efficacité des traitements.

Skills

Collaboration

Analyse de données

Intervention en crise

Education

Master’s Degree en travail social ou un domaine connexe

Bachelor’s Degree en soins infirmiers (pour RNs)

Job description

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.

We’ve stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.

Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients’ success.

Job Description

Description:

Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health services provided in inpatient and intermediate care settings. Collects and analyzes utilization data. Assists with discharge planning and ambulatory follow up activity. Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects.

ESSENTIAL FUNCTIONS:

• Monitors inpatient and intermediate level of care services related to mental health treatment to ensure medical necessity and effectiveness.
• Provides telephone triage, crisis intervention and emergency authorizations as assigned.
• Performs concurrent reviews for inpatient care and other levels of care as allowed by scope of practice and experience. In conjunction with providers and facilities, develops discharge plans and oversee their implementation. Provides information to members and providers regarding mental health 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.
• Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.
• Advocates for the patient to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process.

Qualifications

• License: LCSW, LMFT or RN. REQUIRE a Master’s Degree. RNs REQUIRES a Bachelor’s Degree
• Hours: The department hours are from 8am – 8pm.
• The selected candidates will work an 8 hour shift between the operational hours depending on the business needs. CANDIDATES MUST BE FLEXIBLE!!!
• Training:2 – 3 weeks

Additional Information

All your information will be kept confidential according to EEO guidelines.