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Schedule: Sunday -Thursday 8am-5pm EST
Position specific details: The successful candidate will be licensed and domiciled in Indiana. This is hybrid/remote role where the hired candidate may be asked to work in office as needed.
The Behavioral Health Care Manager I - Indiana is responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.
Primary duties may include but are not limited to:
Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract.
Refers cases to Peer Reviewers as appropriate.
Performs psychiatric and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources.
Position requirements:
Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background.
Current active unrestricted license, such as RN, LCSW, LMHC, LPC, LMFT to practice as a health professional within the scope of licensure in applicable states or territory of the United States required.
Licensure is a requirement for this position.
Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.
For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.