UM Care Manager, Enhanced Care - Northeast Region in Boston, MA at Beacon Health Options

Date Posted: 10/15/2018

Job Snapshot

Job Description

About the Position:

We are currently seeking a dynamic UM Care Manager, Enhanced Care to join our Utilization Management team remotely! The Enhanced Care Coordinator (ECC) works with providers and treatment teams to review and assess appropriate levels of care, and ensure members are receiving care that appropriately meets their clinical criteria and the members’ needs. ECC provides clinical service coordination and case management services to identified Beacon Health Plan members that may experience high utilization of both psychiatric inpatient and detoxification services. ECC may engage in face-to-face or offsite meetings with members and their treatment coordinators/providers. ECC coordination is to provide ongoing active involvement with other state agency services and programs, frequent ESP utilization and/or co-existing medical and behavioral health problems. 

*This is a remote / work at home opportunity for applicants licensed in the state of Massachusetts*

Position Responsibilities:

  • Make clinical decisions related to assessment, referral, coordination of care, and appropriateness of care for members seeking access to their benefits for Mental Health or Substance Abuse services for all levels of care covered by contracts
  • Meet departmental standards related to clinical documentation, clinical policies and procedures, accreditation and regulatory standards and contract compliance
  • Actively participate in clinical rounds/case review process, and seeks consultation with the Clinical Director and Medical Director
  • Actively participate in designated processes for managing the care of high-risk members
  • Ensure the integration of services through ongoing communication with the provider(s) involved in the case; establish linkages to family service agencies, community services organizations, the court system, schools, external case management providers, and other appropriate resources
  • Initiates  interdisciplinary  meetings with Acute care settings, providers, members, guardians and State agencies  to assist in disposition plans and  the development of individualized treatment plans, as needed
  • Provides linkages to state agencies and community service organizations who can provide needed services

Position Requirements:

  • Education: Master’s degree in social work, psychology, mental health, nursing, or other related field required
  • Licenses: Current, valid, unrestricted clinical license in Massachusetts (incl. LMHC, LICSW, LMFT, RN, PhD.) required in the state of Massachusetts
  • Relevant Work Experience:1year post-licensure clinical experience providing direct care required

To Apply:

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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

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