ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles.
The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers.
If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps.
Must have:
Full clinical licensure with master's degree in social work, counseling, or similar area; License must be active in state employee works/lives.
Minimum of 5 years' experience post-licensure in healthcare, behavioral health, social work, psychiatric and/or substance use disorder setting.
LCMFT - Licensed Clinical Marriage and Family Therapist - Care Mgmt, LCSW-C - Licensed Certified Social Worker - Clinical - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LPCC - Licensed Professional Clinical Counselor - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt
Under supervision of clinical leadership, the navigator is a phone queue based role responsible for answering calls from Magellan members, individual providers, facilities, and customer representatives. May provide utilization management review and authorization of behavioral health and substance use disorder services ranging from outpatient counseling to inpatient levels of care. May assist with connection to Employee Assistance Program (EAP) services including counseling, coaching, Critical Incident Response and Workplace Support Services (WPS). Responsible for triaging calls, determining level of risk, managing crisis calls, and assessing members for all types of risk following Magellan's established crisis call protocols. Navigator will be assigned additional responsibilities based on experience, including training and mentoring newly hired navigators.
Manage EAP service requests within scope of clinical role including in the moment telephonic consultation, connection to EAP counseling, education and connection to other EAP benefits. Conduct risk assessment and assessment of social determinants of health needs on all calls. Provide WPS Supervisor Consultations, manage requests for Critical Incident Response, submit requests for urgent/routine member appointment searches. (30%)
Provide utlization management review and authorization of behavioral health and substance use disorder services ranging from outpatient to inpatient levels of care utilizing applicable Medical Necessity Critera (MNC) guidelines. Assist members and facilities in coordinating and accessing benefit eligible treatment. (30%)
Provide crisis call management. Follow crisis call protocols and connect to emergency services, mobile crisis response, and/or other crisis resources as appropriate. Outreach to members assessed as high risk. (20%)
Assist members with accessing benefit eligible EAP, BH, or SUD treatment via bed searches and routine/urgent apointment searches. Manage requests and complete outreach for Critical Incident Response event staffing. (10%)
When off queue, other responsibilities include completing required corporate and clinical trainings, participation in individual supervision and team meetings, gathering and submitting customer feedback, supporting Magellan holiday phone queue coverage and assisting with training/mentoring of new hires and existing staff. (10%)
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Additional Qualifications/Responsibilities
Full clinical licensure with master's degree in social work, counseling, or similar area; License must be active in state employee works/lives.
Minimum of 5 years' experience post-licensure in healthcare, behavioral health, social work, psychiatric and/or substance use disorder setting.
Strong organization, time management, and communication skills.
All new hires will need to be master's level licensed clinicians.
CEAP certification as required by management.
Knowledge of utilization management procedures, mental health, and substance abuse community resources and providers.
Knowledge of and experience in inpatient setting.
Knowledge of DSW V or most current diagnostic edition.
Ability to analyze specific utiliation problems and plan and implement solutions that directly influence quality of care.
Strong computer skills to utilize and navigate various systems.
General Job Information
Title
Sr. Clinical Care Navigator
Grade
26
Work Experience - Required
Behavioral Health, Care Management, Social Work
Work Experience - Preferred
Education - Required
Master's - Counseling, Master's - Social Work
Education - Preferred
License and Certifications - Required
LCMFT - Licensed Clinical Marriage and Family Therapist - Care Mgmt, LCSW-C - Licensed Certified Social Worker - Clinical - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LPCC - Licensed Professional Clinical Counselor - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt
License and Certifications - Preferred
Salary Range
Salary Minimum:
$70,715
Salary Maximum:
$113,145