Care Manager - BH

Magellan Health; United States; Remote; USD 58,000 - 94,000; Full time

Job summary

An established industry player is seeking a dedicated Care Manager to oversee mental health and substance abuse services. This vital role involves authorizing care, developing discharge plans, and ensuring effective treatment for members. The ideal candidate will have strong communication and organizational skills, with a solid background in behavioral health. Join a team committed to improving patient outcomes while enjoying a comprehensive benefits package and opportunities for professional growth. If you're passionate about making a difference in the lives of others, this is the perfect opportunity for you.

Benefits

Comprehensive Health Benefits

Life Insurance

Voluntary Benefits

Short-term Incentives

Qualifications

• Requires licensure such as LCSW, LPC, or RN.
• Minimum 2 years experience in healthcare or behavioral health.
• Knowledge of DSM V and utilization management procedures.

Responsibilities

• Authorizes and reviews mental health and substance abuse services.
• Develops discharge plans and oversees implementation.
• Participates in quality improvement activities and data analysis.

Skills

Organizational Skills

Time Management

Communication Skills

Utilization Management Knowledge

Mental Health Knowledge

Substance Abuse Knowledge

Analytical Skills

Education

Associate in Nursing

Bachelor's in Social Work

Master's in Social Work

Job description

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

• 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.

Other Job Requirements

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 licensure is required for this role with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN.
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 outpatientsetting.
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.

General Job Information

Title

Care Manager, BH

Grade

24

Work Experience - Required

Clinical

Work Experience - Preferred

Education - Required

Associate - Nursing, Bachelor's - Social Work, Master's - Social Work

Education - Preferred

License and Certifications - Required

CEAP - Certified Employee Assistance Professional - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, LSW - Licensed Social Worker - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt

License and Certifications - Preferred

Salary Range

Salary Minimum:

$58,440

Salary Maximum:

$93,500

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.