This job will have the following responsibilities:
The BH Care Manager (UM) job progression is primarily a provider facing role although it does involve some member facing activities such as collecting information and using clinical knowledge and expertise to ensure our members are directed to the appropriate level of care.
Primary duties may include, but are not limited to: Uses appropriate screening criteria, knowledge and clinical judgment to assess member needs to ensure access to medically necessary, quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract.
Refers cases to Peer Reviewers as appropriate. Performs psychiatric and substance abuse or substance abuse disorder assessment, coordination, implementation, case planning, monitoring, and evaluating to promote quality member outcomes, to optimize member health benefits, and to promote effective use of health benefits and community resources.
Qualifications & Requirements:
Requires MS or MA in social work, counseling, nursing or a related behavioral health field.
3 years experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background.
Current active unrestricted license as an RN, LCSW, LMSW, LMHC, LPC, LBA, LMFT, or Clinical Psychologist.
Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.
Contact: khawkins@judge.com
This job and many more are available through The Judge Group. Find us on the web at www.judge.com
