Care Manager, BH Remote Bedford PA

ATTENTION MILITARY AFFILIATED JOB SEEKERS- Our organization works with partner companies to source qualified talent for their open roles. The following position is available toVeterans Transitioning Military National Guard and Reserve Members Military Spouses Wounded Warriors and their Caregivers. If you have the required skill set education requirements and experience please click the submit button and follow the next steps. Unless specifically stated otherwise this role is On-Site at the location detailed in the job post.

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.
The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job without revision to the job description.

Additional Qualifications/Responsibilities
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 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.
General Job Information

Title

Care Manager BH - Remote in PA Bedford Somerset
Grade

24
Work Experience - Required

Clinical
Work Experience - Preferred

Education - Required

Associate - Nursing Bachelors - Social Work Masters - Social Work
Education - Preferred

License and Certifications - Required

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

Salary Range

Salary Minimum:

$58440
Salary Maximum:

$93500
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 individuals 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.