Care Manager, BH – Louisiana License Required

🕒 il y a 4 jours

⚜️ Louisiana – Distant

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💵 $64 285 - $102 855 / an

⏰ Temps Plein

🟢 Junior

🟡 Intermédiaire

👔 Manager

🦅 Parrain de Visa H1B

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👻 Score fantôme 0%

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🗣️🇺🇸🇬🇧 Anglais requis

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Logo of Magellan Health

Magellan Health

1001 - 5000 employés

💼 Conseil

🛡️ Assurance

🏥 Santé

💰 €101 000 000 Private Equity Round en 2004-01

Consulting • Insurance • Healthcare

Magellan Health est une entreprise de gestion de soins de santé de premier plan qui offre une gamme de services, y compris la santé comportementale, la gestion des pharmacies et des programmes d'assistance aux employés. L'entreprise se concentre sur la fourniture de soins et de soutien de haute qualité aux individus et aux familles, en particulier ceux évoluant dans des environnements militaires et communautaires. Magellan Health met l'accent sur un service personnalisé et des solutions innovantes pour améliorer les résultats de santé et enrichir l'expérience globale du patient.

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 and activities • Monitor inpatient and/or outpatient levels of care for medical necessity and effectiveness • Provide telephone triage, crisis intervention and emergency authorizations • Perform concurrent reviews for inpatient/outpatient care and other levels of care within scope of practice and experience • Develop discharge plans with providers and facilities and oversee implementation • Perform quality clinical reviews and educate members and providers • Provide information about benefits, community resources, managed care programs, policies, procedures and criteria • Discuss clinical and authorization questions with Physician Advisors • Maintain workload according to National Care Manager performance standards • Work with community agencies • 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

🎯 Exigences

• Current license meeting State, Commonwealth or customer-specific requirements • One or more required licensure options with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN • 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 utilization problems and implement solutions influencing quality of care • Associate degree in Nursing, Bachelor's degree in Social Work, or Master's degree in Social Work • Louisiana licensure required

🏖️ 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 • Tobacco-free workplace

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