Behavioral Health Care Manager I - Florida
Core
Manage psychiatric and substance abuse facility-based and outpatient professional treatment health benefits through telephonic or written review, including assessment coordination, case planning, monitoring, and crisis assessment.
Role type
Licensed behavioral health utilization manager
Builds
Health benefit utilization decisions and care coordination for members
Domain
Healthcare / Behavioral Health / Utilization Management
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Clinical judgment, case planning, crisis assessment, screening criteria application, contract compliance, resource coordination
Preferred skills
Complex psychiatric/substance abuse case management, inpatient/outpatient service experience
Technologies
Telephonic review systems, clinical guidelines databases
Responsibilities
Assess member needs for medically necessary behavioral healthcare, refer cases to peer reviewers, handle crisis calls and safety assessments, monitor and evaluate treatment plans
Seniority
Individual Contributor, Licensed Professional