Care Manager, BH – Louisiana License Required

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

📋 Description

• Authorize and assess the use of mental health and substance abuse services in both inpatient and outpatient care environments.

• Gather and evaluate utilization data.

• Assist in discharge planning and coordination of care.

• Offer support to members regarding mental health and substance abuse concerns.

• Engage in quality improvement initiatives and activities.

• Monitor inpatient and outpatient levels of care for medical necessity and efficiency.

• Provide telephone triage, crisis intervention, and emergency authorizations.

• Conduct concurrent reviews for inpatient and outpatient care, along with other levels of care within the scope of practice and expertise.

• Collaborate with providers and facilities to develop discharge plans and ensure their execution.

• Perform thorough clinical reviews and educate both members and providers.

• Share information about benefits, community resources, managed care programs, policies, and criteria.

• Discuss clinical and authorization inquiries with Physician Advisors.

• Maintain workload in accordance with National Care Manager performance standards.

• Collaborate with community organizations.

• Suggest alternative treatment plans when services do not align with medical necessity standards.

• Contribute to network development by identifying and recruiting quality providers.

• Advocate for patients while maintaining professional interactions with providers.

⛳️ Requirements

• Active license that meets State, Commonwealth, or customer-specific criteria.

• One or more required licensure options with relevant degrees: CEAP, LMSW, LCSW, LSW, LPC, or RN.

• A minimum of 2 years of experience post-degree in healthcare, behavioral health, psychiatric, and/or substance abuse settings.

• Excellent organizational, time management, and communication abilities.

• Familiarity with utilization management protocols, as well as mental health and substance abuse community resources and providers.

• Experience in both inpatient and outpatient settings.

• Knowledge of DSM V or the most current diagnostic edition.

• Capacity to analyze utilization issues and apply solutions that enhance the quality of care.

• Associate degree in Nursing, Bachelor's degree in Social Work, or Master's degree in Social Work.

• Louisiana licensure is mandatory.

🏝️ Benefits

• Short-term incentives may be available.

• Comprehensive benefits package.

• Health, life, voluntary, and other benefits.

• Benefits and perks that promote physical, mental, emotional, and financial wellbeing.

• Tobacco-free workplace.