Case Manager

Integrated Resources, Inc

Alpharetta, Georgia(remote)

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JOB DETAILS

JOB TYPE

Full-time

SKILLS

Analysis Skills, Behavioral Health, Biology, Case Management, Clinical Medicine, Clinical Research, Clinical Validation, Communication Skills, Community Providers, Corporate Policies, Data Analysis, Data Collection, Diagnostic and Statistical Manual of Mental Disorders (DSM), Discharge Plans, Healthcare, Healthcare Providers, Information Technology & Information Systems, Licensed Clinical Social Worker (LCSW), Managed Care, Medical Treatment, Microsoft Outlook, Online Training, Outpatient Care, Patient Care, Patient Care Authorizations, Problem Solving Skills, Project Tracking, Project/Program Management, Psychiatry and Mental Health, Quality Management, Quality of Care, Registered Nurse (RN), Rehabilitation Nursing, Substance Abuse, Substance Abuse Treatment, Time Management, Treatment Evaluation, Treatment Plan, Utilization Management, Work From Home

LOCATION

Alpharetta, Georgia

POSTED

1 day ago

Case ManagerIntegrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.Job DescriptionEducation Level: Master'sThis is a TEMP- TO-PERM Care Manager RN position. The position is created to meet and exceed the service level requirements to their customers.These positions require a Master's Degree and a LCSW or LCPC license.Candidates need 2-3 years of Behavioral Health Experience, and 3-5 years of Utilization Management or Manager Care Experience. She is also looking for candidates with inpatient, outpatient, and behavioral health clinic experience.Under general supervision, and in collaboration with other members of the clinical team, reviews utilization of mental health and substance abuse services provided in inpatient and intermediate care settings. Collects and analyzes utilization data. Assists with discharge planning and ambulatory follow up activity. Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects. Monitors level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.- Performs concurrent reviews for inpatient 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.- 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 Works with community agencies as appropriate. Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria. Advocates for the patient to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process.Requirements/Certifications: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 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.Candidates need 2-3 years of Behavioral Health Experience, and 3-5 years of Utilization Management or Manager Care Experience.She is also looking for candidates with inpatient, outpatient, and behavioral health clinic experience.The manager will give preference to candidates located in the Alpharetta, GA area; however, she is open to remote candidates as well.The Alpharetta, GA candidate will also have the ability to work remote.This is an inbound telephonic position and the selected candidate will manager about 25 calls/day.The majority of the calls are from providers and the other calls are from members and their family members.The selected candidate will have 1-2 years of Managed Care/Clinical Review experience and 3-5 clinical experience.There are 55 people on this team and it is divided into 3 clusters.The training will be web based and it will be about 2-3 weeks long. The hours will be from 8am – 5pm.The selected candidate MUST be comfortable with navigating through multiple systems and comfortable with Outlook, Instant Messenger and Email.QualificationsLCSW or LCPC licenseAdditional InformationRiya KhemLife Science RecruiterIntegrated Resources, Inc.IT Life Sciences Allied Healthcare CROCertified MBE |GSA - Schedule 66 I GSA - Schedule 621I

Case Manager

Integrated Resources, Inc

Alpharetta, Georgia(remote)

About the Company

Integrated Resources, Inc

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