Care Manager, BH

🕒 il y a 9 jours

🔔 Pennsylvania – Distant

🔔 Pennsylvania – Remote

💵 $64 285 - $102 855 / an

⏰ Temps Plein

🟢 Junior

🟡 Intermédiaire

👔 Manager

👻 Score fantôme 0%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Magellan Health

Site WebLinkedInTous les Emplois

1001 - 5000 employés

🏥 Santé

⚕️ Assurance santé

💰 €101 000 000 Private Equity Round - Magellan Health Services en 2004-01

Healthcare • Healthcare Insurance

Magellan Health est une organisation de santé axée sur les services de santé comportementale et la gestion des soins. L'entreprise fournit des gestionnaires de soins cliniques, des conseillers en vie militaire et familiale, et des services de santé comportementale à travers des programmes régionaux (par exemple, Magellan Hawai‘i, Magellan du Nouveau-Mexique), et soutient la coordination des traitements pour les troubles de santé mentale et la toxicomanie. Elle propose également des programmes de soutien aux familles militaires et à d'autres clients institutionnels, indiquant un travail dans la gestion de la santé comportementale et la coordination des soins.

Description

• Authorize and review utilization of mental health and substance abuse services in inpatient and/or outpatient care settings • Collect and analyze utilization data • Assist with discharge planning and care coordination • Provide member assistance for mental health and substance abuse issues • Participate in quality improvement projects • Monitor levels of care to ensure medical necessity and effectiveness • Provide telephone triage, crisis intervention and emergency authorizations • Perform concurrent reviews for inpatient, outpatient and other applicable levels of care • Develop discharge plans with providers and facilities and oversee implementation • Perform quality clinical reviews, educate stakeholders and make interventions to advance member care • Provide information about benefits, community resources, managed care programs, policies, procedures and criteria • Interact with Physician Advisors regarding clinical and authorization questions • Participate in quality improvement activities, including data collection, tracking and analysis • Maintain an active workload according to National Care Manager performance standards • Work with community agencies and propose alternative treatment plans when services do not meet medical necessity criteria • Participate in network development, including identifying and recruiting quality providers • Advocate for patients and interact professionally with providers to facilitate treatment

🎯 Exigences

• Current licensure meeting State, Commonwealth or customer-specific requirements • One or more required licenses/credentials: CEAP, LMSW, LCSW, LSW, LPC or RN • Necessary degree associated with the required licensure • Minimum 2 years of 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 • Must be licensed in Pennsylvania

🏖️ Avantages

• Short-term incentives may be available • Comprehensive benefits package • Health, life, voluntary and other benefits • Benefits and perks supporting physical, mental, emotional and financial wellbeing • Equal Opportunity Employer • Tobacco-free workplace