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CARE MANAGER-CNS in Latham, NY at Beacon Health Options

Date Posted: 12/5/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Care Manager to join our Central Night Service team in the office in Latham, NY area. The Care Manger will conduct telephone assessments, collecting sufficient data to make appropriate referral and certification decisions for emergency/urgent referrals that require alternate levels of care. Makes appropriate certification decisions. Collaborates with providers to determine alternate levels of care and to facilitate transfers to network facilities and providers whenever possible. Facilitates coordination of care with other care managers to assure continuity of care.

Individual may work remotely but most hold active mental/behavioral health license.

Essential Duties and Responsibilities:

Triage Assessment and Referral

  • Complete telephone assessments and referral; gathers demographic and clinical information to connect patient with appropriate provider, including outpatient treatment as necessary; and for emergency, urgent, routine and EAP referrals.
  • Provide appropriate referrals for treatment based in assessment of information gathered during telephone contacts and or on-site with providers.
  • Refer cases that do not meet criteria and need non-cert., to Peer Advisors.
  • Manage release of MHSA benefit provided by carrier for designated group.
  • Ask questions and listen to member in order to assess case and determine needs.
  • Give referral and/or make referral appointment as circumstances warrant.

Clinical Reviews

  • Review for medical appropriateness psychiatric/substance abuse cases utilizing professional knowledge to apply Beacon Health Options criteria and render certification decisions that are within the scope of practice that is relevant to the clinical area under review.
  • Provide reviews for predetermination of medical necessity.
  • Review proposed courses of treatment for medical necessity.
  • Utilize rounds and case consultations to Clinical Supervisor and Peer Advisor for cases outside criteria or not progressing.

Customer Service

  • Interface with internal and external customers to maintain optimal efficiency of service.
  • Maintain telephone superior service standards. Contribute to monthly staff meetings and clinical conferences.
  • Attend appropriate meetings, trainings and conference calls as scheduled.
  • Perform all other aspects of customer service as required.
  • Conduct business in a professional manner.
  • Troubleshoot Clinical issues.
  • Investigate and research to resolve customer complaint problems and issues.

Requirements:

Education: Masters’ degree in social work or psychology or a Bachelor’s level RN. 

Licensures: Appropriately licensed healthcare professionals to manage Utilization Management. Must have a current, valid and unrestricted license in a State or territory of the United States in a mental health field (RN, Ph.D., LCSW/ACSW/LMSW, LLP, MHC, LPC, etc.).  May be required to obtain additional state licensures dependent on client contractual requirements.

Relevant Work Experience: A minimum of 3 years’ experience in psychiatric or substance use treatment. Experience in settings that include inpatient, partial, and/or outpatient care preferred. Experience as a CEAP or EAP internal/external consultant to a work site area required (for the integrated unit.

To Apply:

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled

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