Care Manager, BH

🕒 il y a 10 jours

🔔 Pennsylvania – Distant

🔔 Pennsylvania – Remote

💵 $64 285 - $102 855 / an

⏰ Temps Plein

🟢 Junior

🟡 Intermédiaire

👔 Manager

🦅 Parrain de Visa H1B

Cette entreprise a parrainé des visas H1B par le passé.

👻 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

💼 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 with mental health and substance abuse issues • Participate in quality improvement projects and activities, including data collection, tracking, and analysis • Monitor inpatient and/or outpatient level-of-care services for 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 treatment resources, managed care programs, policies, procedures, and criteria • Interact with Physician Advisors regarding clinical and authorization questions • Maintain 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

🎯 Exigences

• Must be licensed in Pennsylvania • Current license meeting State, Commonwealth or customer-specific requirements • One or more required licensure credentials: CEAP, LMSW, LCSW, LSW, LPC or RN, with necessary degrees • 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 and implement solutions influencing quality of care • Required education: Associate in Nursing, Bachelor's in Social Work, or Master's in Social Work • Required licenses/certifications include CEAP, LCSW, LMFT, LMSW, LPC, LSW, or RN State and/or Compact State Licensure • Compliance with security responsibilities, applicable legal, regulatory, contractual requirements, and internal policies and procedures

🏖️ Avantages

• Short-term incentives may be available • Comprehensive benefits package • Health, life, voluntary and other benefits and perks • Tobacco-free workplace