CARE MANAGER-CNS in Remote at Beacon Health Options

Date Posted: 11/5/2018

Job Snapshot

Job Description

About the Position:

We are currently seeking a Care Manager to join our Central Night Services (CNS) team for our night and weekend shift!

This role will be based remotely and must hold active mental/behavioral health license.

Triage Assessment and Referral Responsibilities:

  • 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 need
  • Give referral and/or make referral appointment as circumstances warrant
  • 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 managers to assure continuity of care

Clinical Review Responsibilities:

  • Review for medical appropriateness psychiatric/substance abuse cases utilizing professional knowledge to apply Beacon Health Options criteria
  • 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 / Administrative Responsibilities:

  • 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
  • Will facilitate all tracking necessary quality indicators to meet the necessary accrediting bodies (NCQA, URAC)
  • Perform special projects and all other duties as assigned

Professional Standard Responsibilities:

  • Apply Beacon Health Options policies and procedures consistently
  • Maintain confidentiality of Clients, Business Records and Reports
  • Maintain ethical and professional standards
  • Maintain individual productivity and performance standards
  • Meet Departmental expectations, accuracy, productivity and performance standards
  • Support Beacon Health Options in achieving Mission Statement
  • Complete tasks accurately and within required timeframes
  • Adhere to the components of the Compliance Program
  • Ensure that job tasks are performed in a legal and ethical manner
  • Actively assess work area for non-compliance issues and notify supervisor or call Ethics Hotline
  • Adhere to compliance training requirements and understand that training is required condition of employment

Position Minimum Requirements:

  • Education: Masters’ degree in social work or psychology required or a Bachelor’s level RN required
  • Licensures: Current, valid and unrestricted license in a State or territory of the United States in a mental health field (RN, Ph.D., LCSW/LMSW, LLP, MHC, LPC, etc.) required
    • May be required to obtain additional state licensures dependent on client contractual requirements
  • Relevant Work Experience: 3 years’ experience in psychiatric or substance use treatment required
    • Experience as a CEAP or EAP internal/external consultant to a work site area required (for the integrated unit)
    • Experience in settings that include inpatient, partial, and/or outpatient care preferred
  • Knowledge, Skills, & Abilities:
    • Must possess the ability to function in an interdisciplinary setting
    • Must have knowledge and experience using management information systems
    • Strong customer service orientation and excellent written and verbal communication skills required
    • Must be knowledgeable about care resources and levels of care availability

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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