Licensed Behavioral Health Manager

3 days ago


Carson City, Nevada, United States Accounting Now Full time
Job Summary

This is a provider-facing role that involves some member-facing activities, such as collecting information and using clinical knowledge and expertise to ensure our members are directed to the appropriate level of care. The successful candidate will be responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.

Key Responsibilities
  • Use 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.
  • Perform 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.
  • Requires a Master's degree in social work, counseling, or a related behavioral health field, or a degree in nursing, and a minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment.
  • Current active unrestricted license, such as RN, LCSW, LMSW, LMHC, LPC, LBA, LMFT, or Clinical Psychologist, to practice as a health professional within the scope of licensure in applicable states or territory of the United States is required.
Requirements
  • Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases is required.
  • Prior managed care experience is required.
  • For URAC accredited areas, the following professional competencies apply: strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.


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