Care Manager - Behavioral Health

Iconma LLC; San Diego (CA); Remote; USD 70,000 - 90,000; Full time

Job summary

A healthcare company is seeking a Behavioral Health Care Manager to work remotely in California. The role involves monitoring and managing care services for mental health and substance abuse, ensuring clinical quality and compliance with medical necessity. Candidates must hold a relevant license and have at least two years of relevant experience. Opportunities for growth and advancement are available.

Benefits

Referral Program

Excellent growth opportunities

Qualifications

• Minimum 2 years experience in healthcare, behavioral health or psychiatric settings.
• Knowledge of utilization management and community resources.
• Experience with DSM V or most current diagnostic edition.

Responsibilities

• Monitors inpatient/outpatient care services related to mental health.
• Develops discharge plans and oversees implementation.
• Participates in quality improvement activities.

Skills

Organization

Time Management

Communication

Education

Licensure (CEAP, LMSW, LCSW, LPC, RN, LPN)

Job description

Our Client, a Healthcare company, is looking for a Behavioral Health Care Manager to work remotely in California.

Responsibilities :

• 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 oversee 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 work load 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.

Requirements :

• Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements. One or more of the following licensure is required for this role with necessary degrees :

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

• Minimum 2 years experience post degree in healthcare, behavioral health, psychiatric and / or substance abuse health care 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.

Why Should You Apply?

• Referral Program
• Excellent growth and advancement opportunities

As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.

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