Care Manager - BH (Onsite, Hollidaysburg, PA)
$64,285–$64,285 year
RemoteHollidaysburg, Pennsylvania, United States
Job Summary
Conduct concurrent reviews for inpatient and outpatient mental health and substance abuse services to ensure medical necessity and effectiveness. Provide member assistance with treatment issues, perform telephone triage, crisis intervention, and emergency authorizations as assigned. Develop and oversee discharge plans in collaboration with providers and facilities while participating in special quality improvement projects. Propose alternative treatment plans when service requests do not meet criteria and advocate for patient needs. Interact with Physician Advisors to discuss clinical questions and work with community agencies to identify quality providers. Maintain an active workload in accordance with National Care Manager performance standards.
Required Qualifications
- Current license that meets State, Commonwealth or customer-specific requirements
- One or more of the following licensure: CEAP, LCSW, LMFT, LMSW, LPC, LSW, or RN
- Minimum 2 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care setting
- Associate degree in Nursing
- Bachelor's degree in Social Work
- Master's degree in Social Work
- Knowledge of utilization management procedures
- Knowledge of 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
- Strong organization skills
- Strong time management skills
- Strong communication skills
- Full time onsite work in Hollidaysburg, PA
Desired Qualifications
- Experience working with maternity population
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