Care Manager - BH After Hours
Magellan HealthAbout the role
This is a Full Time position 40hrs/week CST
Sunday 8:00am -4:30pm
Monday - Wednesday 5:00pm -1:30am
Thursday & Friday OFF
Saturday 8:00am -4:30pm
Minimum Requirements:
Independent behavioral health licensure: LPC, LCSW
Master's degree in behavioral health or other related field
Two year's clinical work experience
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.
- 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.
Other Job Requirements
Responsibilities
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, LSW, LPC or RN.
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.
General Job Information
Title
Care Manager - BH After HoursGrade
24Work Experience - Required
ClinicalWork Experience - Preferred
Education - Required
Associate - Nursing, Bachelor's - Social Work, Master's - Social WorkEducation - Preferred
License and Certifications - Required
CEAP - Certified Employee Assistance Professional - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care MgmtApply for this role
Generate a tailored application kit with a matched cover letter, interview prep, and CV highlights — in under 60 seconds.
Apply Now →Generate Application KitFree account required — sign up in 30s