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Care Manager - BH in Maryland Heights, MO at Integrated Resources, Inc

Date Posted: 12/7/2018

Job Snapshot

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.

  • LCSW - Licensed Clinical Social Worker - Care Mgmt
  • LMSW - Licensed Master Social Worker - Care Mgmt
  • LCPC Licensed professional Counselor- Care Mgmt
  • CEAP - Certified Employee Assistance Professional - Care Mgmt Is a PLUS
  • Candidate must have at least 3 years of experience and a Master's Degree.

Typical Day-
  • This department services over 1000 accounts for various employers
  • The candidate will receive all in-coming calls from a phone que, primarily assessments and triage, candidate will gather demographic info and refer to counselors or facilities for care, candidate my perform crisis interventions, there will be some after call work, on average about 25 calls per day.
  • Candidate must be computer literate.
  • He/She will navigate through multiple systems and he/she must be able to type and talk at the same time.
Candidate must be comfortable working in a cubicle environment and be able to work holidays. Breaks and lunches are scheduled.