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Care Manager, BH
Career Insights for Nursing Home / Home Health Administrator
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What they do
A Nursing Home or Home Health Administrator manages staff and operations at a long term care facility. Oversees admission and care of residents, staff hiring, billing and finances, compliance with regulatory requirements and building maintenance. Maintains professional licensing requirements. Manages staff, recordkeeping, billing, finances, and other administrative work for a home health care program, where aides assist clients with personal, household and some health-related services in their homes.
$92,750 / year median in the U.S.
+11% projected growth
Job Description
- Remote PA page is loaded Care Manager, BH
- Remote PA Apply locations Remote PA Newtown 18940 Remote
- United States time type Full time posted on Posted 3 Days Ago job requisition id
R00000070153
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. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements. One or more of the following licensure is required for this role with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN. Minimum 2 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care setting. Strong organization, time management and communication skills. 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. General Job Information Title Care Manager, BH- Remote PA Grade 25 Work Experience
- Required Clinical Work Experience
- Preferred Education
- Required Associate
- Nursing, Bachelor's
- Social Work, Master's
- Social Work Education
- Preferred License and Certifications
- Required CEAP
- Certified Employee Assistance Professional
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- Licensed Professional Counselor
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- Licensed Social Worker
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- Registered Nurse, State and/or Compact State Licensure
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