Integrated Care Manager – Adult

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

📋 Description

• Facilitate the continuity of care by engaging in a collaborative approach to assess, plan, implement, coordinate, monitor, and evaluate care options and services.

• Ensure that care aligns with individual healthcare needs while fostering quality and cost-effective outcomes.

• Primarily concentrate on case management and provide support for utilization management as necessary.

• Evaluate and gather member data from various care environments.

• Partner with providers, members, and families to execute care plans effectively.

• Manage a high volume of health insurance-related customer calls on a daily basis.

• Clarify benefits, coverage, eligibility, claims, programs, and networks.

• Review medical records to ascertain medical necessity according to established criteria and benefits.

• Provide case status updates to leadership and the medical director as required.

• Collaborate with internal departments, providers, and external organizations.

• Achieve quality, productivity, and timeliness benchmarks.

• Adhere to state, federal, and accreditation compliance standards.

• Ensure documentation is accurate and complete.

• Effectively apply relevant policies and procedures.

• Assist in distributing workload, tracking and reporting team progress, addressing issues and improvement opportunities, and mentoring team members as needed.

• Perform additional duties as assigned.

⛳️ Requirements

• Minimum of 2 years of full-time equivalent experience in providing direct clinical care to consumers.

• Associate’s Degree in a relevant field OR Post High School Nursing Diploma OR Master’s Degree in a behavioral health field, Ph.D., or Psy.D.

• Active, current, unrestricted Arizona behavioral health professional license such as LCSW, LPC, LISAC, LMFT, or licensed psychologist, or active, current, unrestricted RN license in Arizona or a Nurse Licensure Compact state.

• Must secure an approved case management certification within 4 years of hire, such as CCM, CDMS, CMAC, CMC, CRC, CRRC, COHN, RN-C, or RN-BC.

• Intermediate proficiency in PC skills.

• Intermediate experience with office equipment including copiers, fax machines, scanners, and telephones.

• Intermediate capabilities in word processing, spreadsheets, and databases.

• Uphold confidentiality and privacy standards.

• Possess advanced clinical knowledge.

• Exhibit strong interpersonal and active listening skills.

• Ability to interpret and articulate policies and procedures.

• Demonstrate strong analytical and research abilities.

• Possess organizational skills with the capacity to manage multiple priorities.

• Ability to follow directions effectively.

• Skills in team collaboration.

• Sound judgment and problem-solving capabilities.

• Ability to manage and maintain data across different systems.

• Proficient in conflict resolution.

• Ability to represent the organization within the community.

• Availability for full-time work of at least 40 hours per week; additional hours may be necessary based on business requirements.

🏝️ Benefits

• Opportunity for remote work with no regular onsite obligations.

• Flexible Workability workforce strategy.

• Annual continuing education in healthcare, behavioral health, and managed care.