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Care Manager

Care Manager

netPolarity, Inc. (Saicon Consultants, Inc.)Oakland, CA, US
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Job Description

The job details are shared below :

Note this job is only for California location who will be working from remotely only.

Job Title : Care Manager

Job ID : Magellan-2739 -1

Location : 100% REMOTE - CST Working hours

Duration : 3 month contract (10 / 6 / 25 - 12 / 31 / 25)

Pay Rate : $40 / hr.w2

Job Title : Care Manager - Mental Health and Substance Abuse

TOP MUST HAVE SKILLS :

2+ Years Clinical Experience

In behavioral health, psychiatric, or substance abuse healthcare setting

Active Clinical Licensure

(LCSW, LMSW, LPC, LMFT, CEAP, or RN – as per state / customer requirement)

Utilization Management Knowledge

Experience with Mental Health & Substance Abuse Cases

Active Certification Required (must be active in the state you currently reside) : Any one

CEAP - Certified Employee Assistance Professional

  • LCSW - Licensed Clinical Social Worker
  • LMFT - Licensed Marriage and Family Therapist
  • LMSW - Licensed Master Social Worker
  • LPC - Licensed Professional Counselor
  • RN - Registered Nurse
  • State and / or Compact State Licensure

Care Manager - Job Description

Job Overview

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.

Key Responsibilities

  • 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

    • Required Qualifications

  • 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
  • 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

    • Work Experience Requirements

  • Clinical : 2+ years

    • Required Certifications

    Must have one of the following :

  • CEAP - Certified Employee Assistance Professional
  • LCSW - Licensed Clinical Social Worker
  • LMFT - Licensed Marriage and Family Therapist
  • LMSW - Licensed Master Social Worker
  • LPC - Licensed Professional Counselor
  • RN - Registered Nurse
  • State and / or Compact State Licensure

    • Education Requirements

    Dependent on Certification :

  • Associates : Nursing
  • Bachelors : Social Work
  • Masters : Social Work (Required)
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