Projektmanager managing IT and telecommunications projects. Collaborating with various departments and stakeholders to ensure successful project completion at vitroconnect.
About the role
- Behavioral Health Care Manager I managing psychiatric and substance abuse treatment health benefits remotely. Involves member assessments and coordinating care in accordance with UM guidelines.
Responsibilities
- Managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review
- 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
- Refers cases to Peer Reviewers as appropriate
- 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
Requirements
- Requires MA/MS in social work, counseling, or a related behavioral health field, or a degree in nursing
- 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 (as allowed by applicable state laws), LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States
- 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
- Willing to get an OH License or a NC License
- Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred
- Bilingual in Spanish is highly preferred
- Utilization Management experience is preferred
- Previous crisis hotline experience is preferred.
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
- paid holidays
- Paid Time Off
- medical
- dental
- vision
- short and long term disability benefits
- wellness programs
- financial education resources
Job title
Job type
Experience level
Salary
Degree requirement
No Education Requirement
Location requirements
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