Clinical Care Manager in Beaver Falls, PA at Beacon Health Options

Date Posted: 6/11/2018

Job Snapshot

Job Description


We are currently seeking a dynamic Longitudinal Care Manager to join our team at our office in Beaver Falls, PA.  The Longitudinal Care manager will perform mental health/drug and alcohol reviews for complex individuals receiving behavioral health services.

Position Responsibilities:

  • Coordinates with the member and provider to assure that members’ comprehensive treatment needs are met

  • 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

  • Reviews for medical appropriateness psychiatric/substance abuse cases utilizing professional knowledge to apply VBH-PA criteria and renders authorization decisions.Refers cases that do not meet criteria and need non-authorization decision to Peer Advisor

  • Applies utilization management policies and procedures for determination of initial, concurrent and retrospective review

  • 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 : Masters Degree (or appropriate education with RN license)

Licensure:   Licensure in a mental health related field required (RN, PhD, LCSW/ACSW, LPC,   etc.)

Relevant Work Experience :   Minimum of 3 years of experience in psychiatric and substance abuse treatment.

Knowledge, Skills & Abilities :

  • Previous managed care experience preferred.

  • Must have prior experience in settings that include inpatient, partial, and/or outpatient care.

  • Customer service orientation


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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