Description:
- Under general supervision, and in collaboration with other members of the clinical team, the selected candidate will authorizes and
- Collects and analyzes utilization data. Assists with discharge planning and ambulatory follow up activity.
- Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects.
Duties:
- Monitors inpatient and intermediate level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.
- Provides telephone triage, crisis intervention and emergency authorizations as assigned.
- In conjunction with providers and facilities, develops discharge plans and oversee their implementation.
- Performs concurrent reviews for inpatient care and other levels of care as allowed by scope of practice and experience. P
- provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.
- Interacts with Physician Advisors to discuss Clinical/authorization questions and concerns regarding specific cases.
- Department hours: 8am – 6pm. The selected candidate will work from 8:30am – 5pm
- License: LCPC, LCSW, LSW or RN
- The manager is looking for candidates who have at least 1 year of Managed Care exp AND Drug & Alcohol experience.
- She is also looking for someone with community resource experience.
- candidate must be comfortable with working in a cubicle environment, comfortable with typing and talking at the same time, comfortable working in a fast pace environment and comfortable navigating through multiple systems.
- MUST be computer literate.
All your information will be kept confidential according to EEO guidelines.
