Care Manager BH

San Diego, CA 92108

Posted: 02/19/2019 Category: Healthcare Job Number: 22518
Care Manager / Behavioral Health / LMFT / LCSW / LPC 

Looking for a licensed professional  to work as a Care Manager. 100% Telephonic job! Must be willing to work out of San Diego  office.  

Care Manager Job Description Summary
  • Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings. Collects and analyzes utilization data.
  • Assists with discharge planning and care coordination.
  • Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects.
  • Monitors inpatient and/or outpatient 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.
  • Performs concurrent reviews for inpatient and/or outpatient care and other levels of care as allowed by scope of practice and experience.
  • In conjunction with providers and facilities, develops discharge plans and oversee their implementation.
  • Performs quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatment.
  • 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 and authorization questions and concerns regarding specific cases.
  • Participates in quality improvement activities, including data collection, tracking, and analysis.
  • Maintains an active work load in accordance with National Care Manager performance standards.
  • Works with community agencies as appropriate.
  • Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.
  • Participates in network development including identification and recruitment of quality providers as needed.
  • Advocates for the patient to ensure treatment needs are met.
  • Interacts with providers in a professional, respectful manner that facilitates the treatment process.

Degree: Masters Degree 

  • CA license with one or more of the following licensure is required for this role with necessary degrees: LCSW, LPC, or LMFT.(LCMFT - Licensed Clinical Marriage and Family Therapist - Care Mgmt LCSW - Licensed Clinical Social Worker - Care Mgmt LPC - Licensed Professional Counselor - Care Mgmt)
Must have:
  • Strong organization, time management and communication skills.
  • Must be computer savvy with the ability to multi-task and type with high accuracy (min 35wpm) - candidates must take a typing test prior and average WPM must be listed at top of resume in the summary. 
Like to have:
  • Minimum 2 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care setting.
  • Knowledge of utilization management procedures, mental health and substance abuse community resources and providers.
  • Knowledge and experience in inpatient and/or outpatient setting.
  • Knowledge of DSM V or most current diagnostic edition.
  • Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care .
  • 2 weeks classroom training, then 2-6 weeks of side by side training and shadowing (dependent on aptitude of candidate) 
Please Contact: 
Katherine Skelton
877-782-3334, EXT 246

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