Care Manager, BH

🔥 2 minutes ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $64.3k - $102.9k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 • 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

🎯 Requirements

• 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

🏖️ 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 • Equal Opportunity Employer • Tobacco-free workplace