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Behavioral Health Care Manager Mon-Fri 10:00 a.m.--6:30 p.m. w/rotating weekends
4 months ago
Job Brief
PerformCare New Jersey is seeking an experienced Behavioral Health Manager to join their team of professionals. This is a remote position, but you will need to reside within 90 minutes of our Robbinsville, NJ office.
Your career starts now. We are looking for the next generation of health care leaders.
At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to connect with you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
PerfomCare New Jersey
Responsibilities:
As an individual contributor, the Behavioral Health Care Manager (BHCM) is responsible for the daily functions of the clinical department including triage of calls, care coordination and utlization management. The BHCM makes timely intensity of service determinations or refers to higher level review when indicated. Provides linkage to community services as needed. Adheres to customer service level agreements and expected productivity measures. Adhere's to documentation requirements. Identifies a wide range of community resources to caller. Demonstrates respectful communication and excellent customer service. Adheres to recognized ethical standards. Complete all required training on time. Assists with projects asassigned.
The incumbent will be accountable for the following:
Implement all PerformCare Agency and Clinical policies, procedures, and internal processes.
Adhere to all documentation requirements for PerformCare Agency and Clinical policies, procedures, and internal processes.
Conducts clinical screening, make appropriate determinations regarding level of care based on medical necessity criteria, and complete authorizations within established timeframes.
Adhere to all policies and procedures including but not limited to: Employee Handbook, Corporate Code of Conduct, Confidentiality and the Corporate Compliance Program, which includes Fraud, Waste and Abuse.
Other related duties as assigned.
Education/Experience:
Masters degree from an accredited educational program in Social Work, Clinical/Counseling Psychology required.
New Jersey LCSW, LPC, LMFT licensure required.
Minimum three (3) years post graduate clinical experience or equivalent combination of education and cliniclaly related work experience working with a managed care system.
Minimum one (1) year experience in a Behavioral Health Serivces Delivery System preferred.
Knowledge base in Medicaid, Medicare and Commercial Managed Care Systems (MCO's) preferred
Proficient PC Skills and experience utilizing Microsoft Office, Outlook, Excel and PowerPoint preferred.
Ability to provide constructive feedback with a focus on improved quality.
Ability to communicate in a positive/professional manner both orally and written.
Ability to work independently, complete multiple tasks in the allotted timeframe.
Strong problem solving skills and decision making skills.
Ability to work effectively in a team environment.
Other Considerations:
This is a remote position, but you will need to reside within 90 minutes of our Robbinsville, NJ office.
Diversity, Equity, and Inclusion
At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits Package
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
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