Behavioral Health Care Manager I

This is a fully remote position, open to applicants in North Carolina, +1 more state.

📋 Description

• Oversee the management of psychiatric and substance abuse disorder treatment facilities, providing both facility-based and outpatient professional health benefits through telephonic or written evaluations.

• Utilize screening criteria and clinical judgment to evaluate the needs of members.

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

• Refer cases to Peer Reviewers as necessary.

• Conduct assessments for psychiatric and substance abuse disorders, coordinating, implementing, planning, monitoring, and evaluating cases.

• Foster quality outcomes for members while optimizing their health benefits.

• Encourage the effective use of health benefits and community resources.

⛳️ Requirements

• MA/MS in social work, counseling, or a related behavioral health field, 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, to practice within the scope of licensure in applicable states or territories of the United States.

• Licensure is mandatory.

• BCBA is acceptable in states without licensure if the associate solely performs UM approvals, reviews ABA service requests, and is under the supervision of licensed staff.

• Preferred experience in a crisis call center.

• Ohio licensure is highly preferred.

• Bilingual Spanish skills are preferred.

• An independent practice license is highly preferred.

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

• Strong oral, written, and interpersonal communication abilities.

• Effective problem-solving skills.

• Proficient facilitation skills.

• Strong analytical skills.

• Availability to work Monday–Friday, 11 AM–8 PM, including holidays.

🏝️ 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) match.

• Stock purchase plan.

• Life insurance.

• Wellness programs.

• Financial education resources.

• Virtual work flexibility, except for mandatory in-person training sessions.