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Magellan Health Services, Inc.

Sr. Care Manager-BH

Magellan Health Services, Inc. - West Des Moines, IA

Authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and intermediate care settings. Collects and analyzes utilization data. Assists with discharge planning and ambulatory follow up activity; provides member assistance with mental health and substance abuse issues, and participates in quality improvement projects. May be assigned additional special responsibilities commensurate with experience and type of licensure. Will be expected to coach and mentor less experienced Care Managers.ESSENTIAL FUNCTIONS:- Monitors inpatient and intermediate level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.- Performs concurrent reviews for inpatient 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. Provides telephone triage, crisis intervention and emergency authorizations.- Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and Magellan Health Services policies and procedures, and criteria.- Interacts with the company's Medical or Associate Medical Directors and/or Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.- Participates in quality improvement activities, including data collection, tracking, and analysis.- Leads or participates in activities as requested that help improve Care Center performance, excellence and culture. Supports team members and participates in team activities to help build a high-performance team.- TRF?s to be reviewed by Master?s level Care Manager only. RN?s may perform all other related duties.General Job Information TitleSr. Care Manager-BHGrade23Job FamilyCare ManagementCountryUnited States of AmericaFLSA StatusUnited States of America (Exempt)Recruiting Start Date10/3/2017Date Requisition Created10/3/2017Minimum QualificationsEducationAssociates: Nursing (Required), Bachelors: Social Work (Required), MastersLicense and Certifications - RequiredCEAP - 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, PSY - Psychologist - Care MgmtLicense and Certifications - PreferredOther Job RequirementsResponsibilitiesLicensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements.Minimum of 6 years post-degree experience in psychiatric and substance abuse health care.Minimum of 3 years post degree experience for Care Managers with Ph.D. Experience to include utilization review.Licensure may also include one or more of the following: CEAP, LMSW, LCSW or LPN. CEAP certification as required by management.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 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.CompetenciesLanguage(s)Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/DisabledVEVRAA Federal ContractorRequest Priority Protected Veteran ReferralsEOE -Veteran /Disabled/Minority/AA/F/M/SO

8 days 14 hours ago

Magellan Health Services, Inc.

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Location: West Des Moines, IA

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.