Behavioral Health Care Manager I

This is a fully remote position, open to applicants in Florida.

📋 Description

• Oversee psychiatric and substance abuse disorder treatment health benefits for facility-based and outpatient services through telephone or written evaluations.

• Utilize knowledge of screening criteria and clinical judgment to evaluate member requirements.

• Guarantee access to necessary, quality behavioral healthcare in a cost-effective manner, adhering to UM Clinical Guidelines and contractual obligations.

• Refer cases to Peer Reviewers when appropriate.

• Coordinate, implement, plan, monitor, and assess psychiatric and substance abuse evaluations.

• Foster quality outcomes for members and maximize health benefits.

• Encourage effective utilization of health benefits and community resources.

• Manage crisis calls and evaluate member safety.

⛳️ Requirements

• MA/MS in social work, counseling, or a related behavioral health discipline, or a nursing degree.

• At least 3 years of experience in facility-based and/or outpatient psychiatric and substance abuse disorder treatment.

• Current active unrestricted license, such as RN, LCSW, LMSW, LMHC, LPC, LBA, LMFT, or Clinical Psychologist, enabling practice as a health professional within the scope of licensure in relevant states or territories of the United States.

• Licensure is mandatory for this role.

• In states without licensure requirements, a BCBA is acceptable only if the associate solely performs UM approvals, reviews ABA service requests exclusively, and is supervised by licensed staff.

• Previous experience in case management/utilization management with complex psychiatric/substance abuse cases is preferred.

• Prior experience in behavioral health inpatient and/or outpatient services is preferred.

• Strong oral, written, and interpersonal communication abilities.

• Proficient problem-solving skills.

• Effective facilitation skills.

• Strong analytical abilities.

• Must be licensed and reside in Florida.

• Ability to work from 9 am to 6 pm EST with occasional rotating coverage on holidays and weekends.

• Candidates should live within a reasonable commuting distance from the job locations unless accommodation is provided as mandated by law.

• COVID-19 and Influenza vaccinations are required for specific patient/member-facing roles, subject to acceptable justification.

🏝️ Benefits

• Merit increases.

• Paid holidays.

• Paid Time Off.

• Incentive bonus programs.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• Short-term disability benefits.

• Long-term disability benefits.

• 401(k) with matching contributions.

• Stock purchase plan.

• Life insurance.

• Wellness programs.

• Financial education resources.

• Virtual full-time work arrangement, except for mandatory in-person training sessions.

• Flexible work-life integration.

• Opportunities for professional growth.