Care Coordination Manager
1 week ago
As a Clinical Care Manager at Community Behavioral Health, you will be responsible for conducting utilization review activities, population management, cross-system consultation, provider management, and treatment quality monitoring. You will utilize your clinical knowledge of best practices and evidence-based treatments to ensure CBH members receive timely access to quality, medically necessary behavioral health services.
Key Responsibilities:
- Conduct interagency meetings, social determinants interviews with members, treatment team meetings, case consultations, care coordination, provider meetings, reviews, treatment linkage
- Autorize treatment when Medical Necessity Criteria is met
- Consult with Physician Advisor, Psychologist Advisor, and/or Clinical Leadership as clinically appropriate
- Generate denial letters based on physician reviews and in accordance with state regulations as needed
Required Skills and Qualifications:
- Masters degree in Social Work or related field
- Clinical licensure (e.g. LSW, LPC, LMFT, LCSW)
- Minimum 3 years of direct clinical care experience working with adults, children, adolescents, and/or their families in behavioral health settings
Benefits:
- Competitive salary
- Benefits package including medical, dental, and vision insurance
- Retirement plan
Others:
- Must be able to travel within Philadelphia and surrounding counties
- Regularly requires walking, standing, stooping, bending, sitting, reaching, pushing, pulling, and/or repetitive wrist/hand movements for various lengths of time throughout the day
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