Care Manager in Seven Fields, PA at Beacon Health Options

Date Posted: 7/23/2019

Job Snapshot

Job Description


We are currently seeking a dynamic VRC Complex Care Manager to join our team at our office in Seven Fields, PA!  The VRC Complex Care manager provides intensive care management services to those individuals who are identified as high utilizers/complex cases.  Reviews and manages care through all levels of care, facilitates after care plans and linkages with community resources.  Will have regular contact with individuals/providers to encourage adherence with treatment recommendations and flexibility to attend treatment team meetings.      Facilitates coordination of care with other behavioral health and physical health entities to assure continuity of care.  Evaluates clinical appropriateness of treatment using professional knowledge within VBH-PA medical necessity guidelines and renders authorization decisions or seeks peer advisor consultations for non-authorization decisions.  The primary goal of the longitudinal complex care manager is to help individuals maintain community tenure, regain optimal health, improve life functioning capability and to promote resiliency and recovery.

Position Responsibilities:

  1. Coordinates with the member and provider to assure that individual’s comprehensive treatment needs are met.
  2. Completes telephone assessments and referrals; gathers demographic and clinical information to connect member with appropriate provider, including outpatient treatment as necessary; and for emergency, urgent, and routine referrals
  3. Reviews for medical appropriateness psychiatric/substance abuse cases utilizing professional knowledge to apply VBH-PA criteria and renders authorization decisions
  4. Applies utilization management policies and procedures for determination of initial, concurrent and retrospective review
  5. Refers cases that do not meet criteria and need non-authorization decision to Peer Advisor
  6. Utilizes clinical rounds/supervision and case consultations with Clinical Supervisor/Manager and Peer Advisor for cases that do not meet medical necessity criteria

Position Requirements: 
Education: Master’s Degree in a mental health related field required (or Associates Degree with RN license)
Licensure:  This position requires licensure in a mental health related field (RN, PhD, LPC, LCSW/ACSW, etc.)Insert required and/or preferred license
Relevant Work Experience: 
*Minimum of (3) three years of experience in psychiatric and substance abuse treatment. 
*Experience in settings that include inpatient, partial, and/or outpatient care preferred. 
*Previous managed care experience preferred.
Knowledge, Skills & Abilities:

  • MS Office
  • Analytical Skills

 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

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email ( Only candidates who have applied for an open position through our Careers page ( will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.