Behavioral Health Care Manager I
Core
Manage psychiatric and substance abuse facility-based and outpatient professional treatment health benefits through telephonic or written review to ensure access to medically necessary quality behavioral healthcare.
Role type
Licensed Behavioral Health Care Manager (Utilization Management)
Builds
Member access to psychiatric and substance abuse treatment services
Domain
Healthcare / Behavioral Health / Utilization Management
Deliverable
client delivery
Required skills
Clinical judgment, screening criteria knowledge, case planning, monitoring, evaluating outcomes, referral management
Preferred skills
Utilization management experience, complex psychiatric/substance abuse case experience
Technologies
Telephonic review systems, clinical guidelines databases
Responsibilities
Assess member needs using screening criteria and clinical judgment, refer cases to Peer Reviewers, coordinate psychiatric and substance abuse assessment implementation, monitor and evaluate treatment plans to optimize health benefits use
Seniority
Individual Contributor, Licensed Professional