CARE MANAGER-CRL in Cypress, CA at Beacon Health Options

Date Posted: 7/6/2018

Job Snapshot

Job Description

General Summary    

In a clinical call center environment, clinician provides telephonic assessments, referrals and brief clinical interventions to make appropriate referral and certification decisions for routine and emergent/urgent referrals requiring for all levels of care. Facilitates transfers to network facilities and providers whenever possible.  Facilitates coordination of care with other care managers to assure continuity of care.  Evaluates clinical appropriateness of treatment using professional knowledge within company clinical and worksite guidelines.

Duties and Responsibilities

  1. Works in a high-volume, clinical call center environment, answering inbound calls to assist members access mental health, substance use and employee assistance programs
  2. Conducts brief telephonic, clinical assessments to determine appropriate level of care, per Beacon Health Options/ValueOptions of California (VOC) criteria for medical necessity, and connects callers accordingly.
  1. Must be knowledgeable about care resources and levels of care available
  1. Coordinates with other Clinical Care Managers to assure that patient comprehensive treatment needs are met
  1. Utilizes case consultations with Clinical Management Team and Medical Director for complicated or clinically urgent cases
  1. Maintains confidentiality and ethical and professional standards
  1. Applies Beacon Health Options/VOC policies and procedures consistently
  1. Maintains individual productivity and performance standards
  1. Interfaces with external and internal customers to ensure optimal efficiency of service
  1. Maintains telephone service standards
  1. Contributes to staff meetings and clinical conferences.

Minimum Entry Level Qualifications

  • Education:     Minimum of a master’s degree in mental health related discipline or a minimum of an associate’s degree in nursing with related psychiatric nursing experience.

  • Licensures:     Current, valid and unrestricted license in a mental health field (RN, Ph.D., LCSW, LMFT or LPC).

Years and Type of Relevant Work Experience:

  • Three to five years direct practice experience in psychiatric or substance abuse treatment.  Experience in settings that include inpatient, partial, and/or outpatient care preferred. For some roles experience as a CEAP or EAP internal/external consultant to a work site area may be required.