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Magellan Health Services, Inc.

Care Manager, BH - Overnights shift

Magellan Health Services, Inc. - Maryland Heights, MO

Job Description:

*** This position is for our After Hours dept. position ***

Schedule: Monday – Friday 11:30pm -7:30am CST

Job Description:

Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings. Collects and analyzes utilization data. Assists with discharge planning and care coordination. Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects.

ESSENTIAL FUNCTIONS:

- 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,

may develop discharge plans and oversee their implementation. May also perform 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.

Minimum Requirements:

- Independent behavioral health licensure: LPC, LCSW

- Master's degree in behavioral health or other related field

- Two year's clinical work experience

- 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.

General Job Information

Title

Care Manager, BH - Overnights shift

Grade

22

Job Family

Clinical Services Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

7/29/2018

Date Requisition Created

12/24/2017

Minimum Qualifications

Education

Associates Nursing||&& Bachelors Social Work||&& Masters Social Work

License and Certifications - Required

CEAP - Certified Employee Assistance Professional - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, LPN - Licensed Practical Nurse - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt

License and Certifications - Preferred

Other Job Requirements

Responsibilities

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.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled

Apply Now

General Job Information

Title

Care Manager, BH - Overnights shift Grade 22

Job Family

Clinical Services Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

7/29/2018

Date Requisition Created

12/24/2017

Minimum Qualifications

Education

Associates Nursing||&& Bachelors Social Work||&& Masters Social Work

License and Certifications - Required

CEAP - Certified Employee Assistance Professional - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, LPN - Licensed Practical Nurse - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt

License and Certifications - Preferred

Other Job Requirements

Responsibilities 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.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled >

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19 days 21 hours ago

Magellan Health Services, Inc.

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Please review all application instructions before applying.

Location: Maryland Heights, MO

Company Profile:
As a health care management company, we focus on today's most complex and costly health care services. The depth and breadth of our experience in managing behavioral health care, diagnostic imaging, specialty pharmaceutical services and in providing pharmacy benefits administration enable us to deliver inspired insights and innovative solutions that positively impact both the quality and the cost of some of the nation's fastest growing areas of health care.