Care Manager, BH

🕒 July 14

🔔 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 12%

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

💼 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 for mental health and substance abuse issues • Participate in special quality improvement projects • Monitor inpatient and/or outpatient 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 make interventions to advance member care • Provide members and providers with information about benefits, community resources, managed care programs, policies, procedures, and criteria • Consult Physician Advisors regarding clinical and authorization questions • Participate in quality improvement 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

🎯 Requirements

• 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 healthcare 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 plan and implement solutions influencing quality of care • Associate degree in Nursing, Bachelor's degree in Social Work, or Master's degree in Social Work required • Required certification/licensure: CEAP, LCSW, LMFT, LMSW, LPC, LSW, or RN state and/or compact state licensure

🏖️ Benefits

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