8/6/2018
Magellan Health
Ex. F 004
M H
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Care Manager - BH Brooklyn NY 11201
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Posted 30+ Days Ago
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Full time R00000019419
Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and sub‐ stance 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 sub‐ stance abuse issues, and participates in special quality improvement projects. ESSENTIAL FUNCTIONS: - Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effec‐ tiveness. - 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, may develop discharge plans and oversee their implementation. May also perform 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 ques‐ tions and concerns regarding specific cases. - Participates in quality improvement activities, including data collection, track‐ ing, and analysis. - Maintains an active work load in accordance with National Care Manager performance standards. Works with community agencies as appropriate. Pro‐ poses 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.
About Us
Magellan is the employer of choice for hard working people interested in mak‐ ing a difference in the health care indus‐ try and in the communities where we work and live. Our strong culture of car‐ ing is the common thread in both our business strategy and our work environ‐ ment. We value professional growth and development, total health and wellness, rewards and recognition as well as em‐ ployee unity. Magellan is a place where you can thrive. Click here to search our openings. Magellan is committed to providing equal employment opportunities to em‐ ployees and applicants for employment without regard to race, color, creed, reli‐ gion, sex, gender identity and expression, sexual orientation, marital status, age,
https://magellanhealth.wd5.myworkdayjobs.com/en-US/magellan_health_careers/job/Brooklyn-NY-11201/Care-Manager---BH_R00000019419?_ga=2.254296712.1…
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8/6/2018
Ex. F 005
Magellan Health
General Job Information
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national origin, ancestry, citizenship,
physical or mental disability, disabled
Title Care Manager - BH
veteran or veteran of the Vietnam Era
Grade 22
Magellan is committed to meeting ap‐
Job Family Care Management Country United States of America FLSA Status United States of America (Exempt) Recruiting Start Date 6/6/2018 Date Requisition Created 6/6/2018
Minimum Qualifications Education Associates: Nursing (Required), Bachelors: Social Work (Required), Masters: Social Work (Required) License and Certifications - Required CEAP - Certified Employee Assistance Professional - Care Mgmt, LCSW - Li‐ censed Clinical Social Worker - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, LPN - Licensed Practical Nurse - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt
status, or any other factors protected by law.
plicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here. Warning: Employment Scam It has come to our attention that a false representative is contacting potential candidates and offering them work at home positions with Magellan Health. “Interviews” are conducted completely through email and the false job offer in‐ cludes the promise of a check to be is‐ sued to the candidate for the purposes of setting up a home office. Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candi‐ dates to set up home offices. All of our available positions are posted on legiti‐ mate job boards and our recruitment team directly contacts candidates should there be a fit. If you suspect you are being contacted by a false representative of Magellan Health, please call 410-953-2911
License and Certifications - Preferred
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, LPC, RN or LPN. Minimum 2 years experience post degree in healthcare, behavioral health, psy‐ chiatric and/or substance abuse health care setting. Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and sub‐ stance 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 https://magellanhealth.wd5.myworkdayjobs.com/en-US/magellan_health_careers/job/Brooklyn-NY-11201/Care-Manager---BH_R00000019419?_ga=2.254296712.1…
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