Behavioral Health Care Management -

The Health Professional 3 is responsible for performing day-to-day behavioral health/substance abuse care management activities within the guidelines established by APS and under the clinical supervision of a Behavioral Health Medical Director.

Telephonic position focusing on utilization management (UM) of mental health and substance abuse benefits at various levels of care. It includes crisis intervention, clinical assessment, triage, continued stay reviews, discharge planning and aftercare follow-up.
Interacts with medical directors, physician advisors, providers/practitioners, accounts, members and their families, and other internal departments.

The duties of the Clinical Care Manager include, but are not limited to, the following:
� Performs preadmission mental health and substance abuse medical necessity reviews for higher levels of care and documents information gathered and results in system
� Performs concurrent mental health and substance abuse medical necessity reviews for higher levels of care and documents information gathered and results in system
� Evaluates clinical information and appropriately applies APS medical necessity, TAC and ASAM criteria
� Coordinates behavioral health physician review activities with behavioral health medical directors and/or psychiatric physician advisors
� Performs crisis intervention when appropriate
� Identifies, reports, and follows up on quality concerns as appropriate or directed
� Coordination of physical and behavioral health care, as appropriate

Education:
� Master's degree in a behavioral health field and appropriate licensure per state requirement

Qualifications:
� Ability to speak and write Spanish at an advanced level required
� Minimum of 2-3 years of behavioral health clinical experience is required
� Knowledge of DSM-IV TR
� Knowledge of psychotropic medications
� Proficient clinical assessment skills
� Ability to comfortably utilize computer software including Microsoft Outlook, Microsoft Word, Microsoft Excel
� Ability to learn new software programs quickly
� Conduct clinical conversation and transcribe at a conversational speed