
1001 - 5000 employees
🏥 Healthcare
⚕️ Healthcare Insurance
💰 $101M Private Equity Round - Magellan Health Services on 2004-01
Healthcare • Healthcare Insurance
Magellan Health is a healthcare organization focused on behavioral health and care-management services. The company provides clinical care managers, military and family life counselors, and behavioral health services across regional programs (e. g. , Magellan Hawai‘i, Magellan of New Mexico), and supports treatment coordination for mental health and substance abuse conditions. It also offers programs that support military families and other institutional clients, indicating work in managed behavioral health and care coordination.
🔥 4 minutes ago
⚜️ Louisiana – Remote
💵 $64.3k - $102.9k / year
⏰ Full Time
🟢 Junior
🟡 Mid-level
👔 Manager
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1001 - 5000 employees
🏥 Healthcare
⚕️ Healthcare Insurance
💰 $101M Private Equity Round - Magellan Health Services on 2004-01
Healthcare • Healthcare Insurance
Magellan Health is a healthcare organization focused on behavioral health and care-management services. The company provides clinical care managers, military and family life counselors, and behavioral health services across regional programs (e. g. , Magellan Hawai‘i, Magellan of New Mexico), and supports treatment coordination for mental health and substance abuse conditions. It also offers programs that support military families and other institutional clients, indicating work in managed behavioral health and care coordination.
• 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 special 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 and/or 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 treatment 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 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
• Candidates must be licensed in Louisiana • Current license meeting State, Commonwealth, or customer-specific requirements • One or more required licenses/certifications: CEAP, LMSW, LCSW, LSW, LPC, LMFT, 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 settings • Knowledge of DSM V or most current diagnostic edition • Ability to analyze utilization problems and plan and implement solutions that influence quality of care • Required education: Associate in Nursing, Bachelor's in Social Work, or Master's in Social Work
• Short-term incentives may be available • Comprehensive benefits package • Health benefits • Life benefits • Voluntary benefits • Other benefits and perks supporting physical, mental, emotional, and financial wellbeing • Equal Opportunity Employer • Tobacco-free workplace
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