Lead Care Manager, Autism - PA

Magellan Health; United States; Remote; USD 70,000 - 114,000; Full time

Job summary

An established industry player is seeking a dedicated Lead Care Manager specializing in autism services to provide essential support and expertise to Care Managers and clinical teams. This role involves mentoring new staff, resolving complex utilization issues, and ensuring high-quality care through effective data analysis and collaboration with various service providers. With a focus on continuous improvement, this position plays a critical role in shaping care planning and enhancing the overall quality of behavioral health services. Join a forward-thinking organization that values your contributions and offers a comprehensive benefits package to support your well-being.

Benefits

Comprehensive health benefits

Life insurance

Voluntary benefits

Short-term incentives

Tobacco-free workplace

Qualifications

• Must have a state license or national certification in behavioral health.
• Minimum of five years experience in behavioral health is required.

Responsibilities

• Provides support and training to Care Managers and clinical teams.
• Researches and resolves escalated issues for Care Managers.
• Assures coordination of autism services with other providers.

Skills

Behavioral Health Expertise

Utilization Management

Data Analysis

Mentoring and Training

Problem Solving

Education

Master's in Psychology

Master's in Social Work

Master's in Counseling

Job description

Seeking Behavioral Health license such as LCSW, LPC, LMFT, LSW or BCBA certification with a minimum of five years experience in behavioral health.
For the state of Pennsylvania, if only the BCBA certification is held, Behavioral Specialist License (BSL) in the state of Pennsylvania is required.
Knowledge of DSM V or the most current diagnostic edition is essential.
Ability to analyze specific utilization problems, plan, and implement solutions that directly influence quality of care.

Provides support to Care Managers and other clinical team members through content knowledge, technical and utilization management expertise. Researches open questions and unresolved issues for Care Managers who are providing direct utilization management services. Mentors new Care Managers and assists with training. Authorizes and reviews utilization of autism services, including Applied Behavioral Analysis (ABA). Collects and analyzes utilization data. Assists with shaping of ABA services and assures coordination with other service providers such as medical, speech, occupational therapy, physical therapy, and IEP services provided through the school setting. Works with the ABA treatment team to shape care planning and provision and assures measurements of the child’s progress are ongoing. Assures overall case management with the inclusion of behavioral health services when required.

• Provides point of need support and coaching to Care Managers and other clinical team members in the course of normal operations.
• Mentors and trains Care Managers. Serves as a 'buddy' to new Care Managers during their first few months on the job by providing daily support and feedback.
• Researches and resolves escalated issues that frontline Care Managers cannot resolve in a timely fashion.
• Works with the workforce planning team to perform data collection and analysis of trends to determine problem areas and strategies for better practices for the Care Manager team.
• Maintains an active workload in accordance with Care Manager performance standards.
• Performs initial case requests for autism services, behavioral health, and ABA. Reviews all submitted materials and consultations with treatment team providers.
• Provides information to members and providers regarding mental health and autism benefits, community treatment resources, mental health managed care programs, and company policies and procedures.
• Interacts with the company's Medical and Associate Medical Directors and/or Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.
• Leads or participates in team activities to help build a high-performance team.
• Demonstrates flexibility in areas such as job duties and schedule in order to aid the Care Center in better serving its members.
• Assists Care Center efforts to continuously improve by identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.

Other Job Requirements

Responsibilities

Must have one of the following state licenses or national certification:
- Board Certified Behavior Analyst
- Licensed Clinical Social Worker
- Licensed Marriage and Family Therapist
- Licensed Professional Counselor
Minimum five years experience in behavioral health.
Masters in Psychology, Social Work or Counseling.

General Job Information

Title: Lead Care Manager, Autism - PA

Grade: 26

Work Experience - Required: Behavioral Health

Work Experience - Preferred

Education - Required: Master's - Psychology

Education - Preferred

License and Certifications - Required: BCBA - Board Certified Behavior Analyst - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt

License and Certifications - Preferred

Salary Range

Salary Minimum: $70,715
Salary Maximum: $113,145
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.