BH Care Manager II at The Judge Group Inc. in Philadelphia, Pennsylvania

Posted in Other 3 days ago.





Job Description:

Location: REMOTE

Salary: $38.00 USD Hourly - $40.00 USD Hourly

Description: Our client is currently seeking a BH Care Manager II


BH Care Manager


Fully Remote


Part-Time


Saturday- Sunday, 8am-5pm PST


Contract Role


This job will have the following responsibilities:



  • The BH Care Manager (UM) job progression is primarily a provider facing role although it does involve some member facing activities such as collecting information and using clinical knowledge and expertise to ensure our members are directed to the appropriate level of care.

  • Responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.

  • Primary duties may include but are not limited to:


    • Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract.

    • Refers cases to Peer Reviewers as appropriate.

    • Performs psychiatric and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources.

    • Will serve as a resource to other BH Care Managers. Assists with more complex cases and may participate in inter and intradepartmental teams' projects and initiatives.

Qualifications & Requirements:
  • Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background.

  • Current active unrestricted license such as RN LCSW LMHC LPC LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required.

  • Licensure is a requirement for this position.

  • Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required.

  • Prior managed care experience required.

  • Must sit in PST.

Contact: lbraccio@judge.com


This job and many more are available through The Judge Group. Find us on the web at www.judge.com
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