Job Title: Telephonic Care Manager - Behavior Health
Location : Maryland Heights, MO, 63043
Shift: Monday thru Friday 9am - 5:30pm
PAY: $27.00 - $30.00
Behavior Health Social Work Job Description: 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.
- Master’s degree- Missouri license as a professional counselor or clinical social work
- Active state license ( CEAP, LCSW, LPC)
- 2+ years of experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care setting.
- Knowledge of utilization management procedures, mental health and substance abuse community resources and providers.
- Knowledge and experience in inpatient and/or outpatient setting. Microsoft Suite products (Word, Excel, and Outlook).
- Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability
- 401k after 1 year of employment: With employer match and profit sharing
- Competitive Pay Rate!
- Work Life Balance!