Care Manager, BH

🔥 3 minutes ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $64.3k - $102.9k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Magellan Health

WebsiteLinkedInAll Job Openings

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.

📋 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

🎯 Requirements

• 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

🏖️ Benefits

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