The Behavioral Care ManagerII is responsible for managing psychiatric and substance use disorder, facility-based and outpatient professional treatment health benefits through telephonic or written review.
Location: The ideal candidate must reside in the Beckley or Princeton area.
This position is a remote position. Will interface with members and providers in person (field) 2-3 days per week.
How you will make an impact:
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 use 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.
Will serve as a resource to other BH Care Managers.
Assists with more complex cases and may participate in inter and intradepartmental team projects and initiatives.
Minimum Requirements:
Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 3 years of 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 such as RN LCSW LMSW LMHC LPC LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required.
Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required.
