Care Manager, BH

🔥 20 hours ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $64.3k - $102.9k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

👻 Ghost score 0%

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Magellan Health

WebsiteLinkedInAll Job Openings

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.

📋 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 • 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, educate stakeholders, and intervene to advance member care • Provide information about benefits, community treatment resources, managed care programs, company 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

🎯 Requirements

• PA licensed behavioral health professional • Experience working with children and adolescents • Experience with Intensive Behavioral Health Services levels of care, BHRS, and/or ABA preferable • Current license meeting State, Commonwealth or customer-specific requirements • One or more required licenses: 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 • Knowledge of 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 • Education required: Associate - Nursing, Bachelor's - Social Work, or Master's - Social Work • Must comply with applicable legal, regulatory, contractual, security, and internal policy requirements

🏖️ Benefits

• 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 • Equal Opportunity Employer