Offer summary

Qualifications:

Current licensure in a relevant field such as CEAP, LMSW, LCSW, LPC, RN, or LPN is required., Minimum of 2 years of experience in healthcare, particularly in behavioral health or substance abuse settings., Strong organizational, time management, and communication skills are essential., Knowledge of utilization management procedures and DSM V is necessary..

Key responsibilities:

Monitor inpatient and outpatient mental health and substance abuse treatment services for medical necessity and effectiveness.

Provide telephone triage, crisis intervention, and emergency authorizations as needed.

Develop and oversee discharge plans in collaboration with providers and facilities.

Participate in quality improvement activities, including data collection and analysis.

Job description

Our Client, a Healthcare company, is looking for a Care Manager – BH for their Remote location.

Responsibilities:

Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.
Provides telephone triage, crisis intervention and emergency authorizations as assigned.
Performs concurrent reviews for inpatient and/or outpatient care and other levels of care as allowed by scope of practice and experience.
In conjunction with providers and facilities, develops discharge plans and oversee their implementation.
Performs quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatment.
Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.
Interacts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.
Participates in quality improvement activities, including data collection, tracking, and analysis.
Maintains an active work load in accordance with National Care Manager performance standards.
Works with community agencies as appropriate.
Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.
Participates in network development including identification and recruitment of quality providers as needed.
Advocates for the patient to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process.

Requirements:

Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements. One or more of the following licensure is required for this role with necessary degrees:
CEAP, LMSW, LCSW, LPC, RN or LPN.
Minimum 2 years 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.
Clinical 2+ years
Must have one of the following: CEAP - Certified Employee Assistance Professional, LCSW - Licensed Clinical Social Worker, LMFT - Licensed Marriage and Family Therapist, LMSW - Licensed Master Social Worker, LPC - Licensed Professional Counselor, LPN - Licensed Practical Nurse, RN - Registered Nurse, State and/or Compact State Licensure
Dependent on Certification--Associates: Nursing, Bachelors: Social Work, Masters: Social Work (Required)

Why Should You Apply?

Health Benefits
Referral Program
Excellent growth and advancement opportunities

As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.

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