Avondale Estates, GA
Our client is currently seeking a BH Care Manager I
Experience managing patients telephonically and managed care experience preferred.
Must not have had any voluntary surrender of a license, disciplinary action, consent order, monitoring agreement, or settlement agreement imposed, or is any action pending against you, by any licensing board for nurses or any health regulatory board in any jurisdiction/ state/province/country.
Must have a valid, unrestricted license as a Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Clinical Psychologist or a Registered Nurse (RN).
Must have working experiencing using basic MS Windows, Outlook, Excel, typing brief notes into a computer databank during or following a customer call, knowledge of health care industry or medical terminology, working with multiple windows open on PC and ability to move (toggle) back and forth on PC.
Training: We are anticipating a week of training to get the temp able to assist with identified care manager tasks quickly then provided additional training to take on additional tasks as able and needed.
Please note: The BH Care Manager (UM) job progression is primarily a provider facing role although it does involve some member facing activities such as collecting information and using clinical knowledge and expertise to ensure our members are directed to the appropriate level of care. Whereas the BH Case Mgr (CM) job progression is primarily member facing and involves complete clinical assessment. Responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review. Primary duties may include, but are not limited to: Uses appropriate screening criteria, knowledge and clinical judgment to assess member needs to ensure access to medically necessary, quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. Refers cases to Peer Reviewers as appropriate. Performs psychiatric and substance abuse or substance abuse disorder assessment, coordination, implementation, case planning, monitoring, and evaluating to promote quality member outcomes, to optimize member health benefits, and to promote effective use of health benefits and community resources. Requires MS or MA in social work, counseling, nursing or a related behavioral health field; 3 years experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background. Current active unrestricted license as an RN, LCSW, LMSW, LMHC, LPC, LBA (as allowed by applicable state laws), LMFT, or Clinical Psychologist, to practice as a health professional within the scope of licensure in applicable states or territory of the United States required. Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.
Requires an unrestricted clinical license as LCSW, LPC, LMFT, RN or Clinical psychologist. Must have past clinical experience in facility based settings. Prior behavioral health utilization management experience a plus. Position is fully phone and computer based.
Top 3 skillsets: Strong typing/computer skills and behavioral health clinical and/or UM experience and ability to work in a fast- paced environment.
The temp must have full licensure as an RN, LCSW, LPC or LMFT in the state where they reside in. They can be anywhere.
What is your anticipated work schedule for this job posting?
Monday through Friday 8:30am-5:30pm EST.
[ Link removed ] - Click here to apply to BH Care Manager I
- Behavioral Medicine
- Case Management
- Certified Nurse Practitioner
- Clinical Works