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Care Manager - BH

A-Line Staffing Solutions San Diego, CA
  • Expired: over a month ago. Applications are no longer accepted.
Job Description

  A Care Manager is needed for a major Health system in San Diego, CA!

  • 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.

  • 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, LPC, RN or LPN.
  • 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.

M-F 8 AM - 5 PM
?Rate: $33.20

  • Clinical 2+ years

  • Must have one of the following: CEAP - Certified Employee Assistance Professional, LCSW - Licensed Clinical Social Worker, LMFT - Licensed Marriage and Family Therapist, LMSW - Licensed Master Social Worker, LPC - Licensed Professional Counselor, LPN - Licensed Practical Nurse, RN - Registered Nurse, State and/or Compact State Licensure

  • Dependent on Certification--Associates: Nursing, Bachelors: Social Work, Masters: Social Work (Required)

A-Line Staffing Solutions


San Diego, CA