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Behavioral Health Care Manager II
1 month ago
Behavioral Health Care Manager II
This is a remote, individual contributor role; however, it is expected for the person in this role to live in the state of Connecticut. The work schedule is Monday - Friday 8:30 am to 5 pm EST with a late shift rotation of 10:30am-7pm one to three days per month.
The Behavioral Health Care Manager II is responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.
How you will make an impact:
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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.
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Refers cases to Peer Reviewers as appropriate.
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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.
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Will serve as a resource to other BH Care Managers.
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Assists with more complex cases and may participate in inter and intradepartmental teams projects and initiatives.
Minimum Requirements:
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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.
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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 Connecticut required.
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Licensure is a requirement for this position. However, for states that do not require licensure a Board Certified Behavioral Analyst (BCBA) is also acceptable if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervision.
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Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required.
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Prior managed care experience required.
Preferred Qualifications:
- Experience working with children and adolescents with Autism Spectrum Disorder strongly preferred.
