
1001 - 5000 employees
💼 Consulting
🛡️ Insurance
🏥 Healthcare
💰 $101M Private Equity Round on 2004-01
Consulting • Insurance • Healthcare
Magellan Health is a leading healthcare management company that provides a range of services, including behavioral health, pharmacy management, and employee assistance programs. The company focuses on delivering high-quality care and support to individuals and families, particularly those in military and community settings. Magellan Health emphasizes personalized service and innovative solutions to improve health outcomes and enhance the overall patient experience.
🔥 8 minutes ago
⚜️ Louisiana – Remote
💵 $64.3k - $102.9k / year
⏰ Full Time
🟢 Junior
🟡 Mid-level
👔 Manager
🦅 H1B Visa Sponsor
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1001 - 5000 employees
💼 Consulting
🛡️ Insurance
🏥 Healthcare
💰 $101M Private Equity Round on 2004-01
Consulting • Insurance • Healthcare
Magellan Health is a leading healthcare management company that provides a range of services, including behavioral health, pharmacy management, and employee assistance programs. The company focuses on delivering high-quality care and support to individuals and families, particularly those in military and community settings. Magellan Health emphasizes personalized service and innovative solutions to improve health outcomes and enhance the overall patient experience.
• 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
• 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
• 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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