Pädagogische Fachkraft als Teilhabemanager zur Unterstützung von Leistungsberechtigten in Bonn. Koordinierung der Teilhabeplanung und Zusammenarbeit mit Kostenträgern und Einrichtungen.
About the role
- Behavioral Health Care Manager I managing psychiatric and substance abuse treatment through telephonic or written review. Ensuring access to quality behavioral healthcare under UM Clinical Guidelines and contract standards.
Responsibilities
- 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 required
- 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
- Experience in behavioral health utilization management is highly preferred
- Exceptional at multitasking in a fast-paced environment is preferred
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams) is preferred
- Strong typing accuracy skills are highly preferred
- Good communication and organization skills are preferred
- Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
- paid holidays
- paid time off
- medical benefits
- dental benefits
- vision benefits
- short-term disability benefits
- long-term disability benefits
Job title
Job type
Experience level
Salary
Degree requirement
No Education Requirement
Location requirements
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