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UM Care Manager in Little Rock, AR at Beacon Health Options

Date Posted: 1/11/2019

Job Snapshot

Job Description

About the Position:

We are currently seeking a dynamic UM Care Manager to join our team in Little Rock, AR! The UM Clinician performs authorization determinations of mental health and substance use services provided in inpatient, outpatient and/or diversionary care settings. 

Position Responsibilities:

  • Performs telephonic, web based or paper case review and authorization determinations for certification of admissions into Behavioral Health, developmental disability or Substance Use Disorder treatment at any level of care.
  • Determines appropriate level of care related to mental health and substance use treatment for members based on the applicable medical necessity level of care criteria (Beacon proprietary, CMS, ASAM, Interqual or State specific or other required criteria) and ensures that all Beacon’s policy and procedure guidelines, external regulatory requirements and URAC/NCQA accreditation standards are met.
  • Consults with Beacon’s Physician Advisors (PA) when requests for services do not meet medical necessity criteria
  • Interacts with Physician Advisors to discuss clinical/authorization questions, alternative treatment options and concerns regarding specific cases
  • Provides information to members and providers regarding mental health and substance use benefits and community treatment resources when appropriate
  • Recognizes quality of care issues and reports them appropriately through internal and external processes.
  • Interacts with providers and facilities in a professional, respectful manner
  • Demonstrates thorough understanding of product lines and benefit structure for all contracts assigned
  • Handles crisis calls when needed
  • Participates in rounds with medical director or supervisor to discuss clinical determinations of cases

Position Requirements:

  • Education: Master’s degree or higher in a health related field or RN licensure with equivalent psych experience required
  • Licensures: Current, valid, and unrestricted licensed behavioral health clinician; LCSW, LPC or RN required and practice within the scope of their licensure
  • Relevant Work Experience: 5 years behavioral health experience required
  • Knowledge, Skills, & Abilities:
    • Required to be educated in current principles, procedures and knowledge of behavior health. 
    • Keen attention to detail
    • Able to multitask with ease
    • Moderate skill level in MS Office environment (Outlook, Word, Excel, PowerPoint)
    • Good written and verbal communication skills
    • Desire to continually improve problem resolution skills
    • Team player with an ability to work under pressure
    • Ability to remain objective in all dealings with customers and maintain professional attitude
    • Ability to prioritize tasks and accomplish them in a timely fashion
    • Excellent provider/customer relations skills

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