Manager, Clinical Care Services

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

📋 Description

• Oversee, directly manage, and coordinate both clinical and nonclinical management personnel, including those involved in utilization and intensive care management.

• Provide specialized knowledge in assigned programs.

• Support clinical management in the development and ongoing oversight of designated staff.

• Conduct care management review processes in accordance with Magellan's policies, procedures, and standards.

• Recruit, interview, and select qualified candidates while ensuring proper orientation.

• Assess care management staff performance and their compliance with efficiency targets, including case volume, closure rates, average handling time, and other metrics.

• Supervise staff through approved audit mechanisms, conduct annual evaluations, and offer counseling and disciplinary measures as necessary.

• Coordinate quality improvement initiatives under the guidance of clinical management.

• Assist in the formulation of strategic and operational objectives and plans.

• Identify and organize training needs for clinical and client services.

• Analyze utilization challenges and devise and implement solutions to enhance care quality and cost efficiency.

• Oversee the collection of relevant clinical data while maintaining relationships with providers.

• Undertake additional responsibilities aligned with the role's purpose as assigned.

⛳️ Requirements

• A minimum of 5 years of post-degree experience in a direct care clinical environment.

• Experience in managed care is preferred.

• At least 1 year of direct supervisory experience is required.

• One or more current, active licenses are mandatory: BCBA, LCSW, LMFT, LMSW, LPCC, LPC, PC, or RN.

• For RN candidates, a BSN is preferred; an ASN will be considered with additional experience.

• Extensive knowledge of physical, medical specialty, and/or mental health community resources and providers.

• Comprehensive understanding of healthcare services within physical health, behavioral health, or other medical specialty areas.

• Significant skill in interpreting clinical treatment information and making appropriate referral and triage decisions.

• Must fulfill Magellan credentialing criteria for RN, Masters, or Doctoral-level providers.

• Required educational background includes an Associate in Nursing or a Master's degree in Behavioral Health.

• Current licensure must comply with state, Commonwealth, or customer-specific regulations.

• RN candidates must possess state and/or compact state licensure.

🏝️ Benefits

• Short-term incentives may be offered.

• A comprehensive benefits package is available.

• Health, life, voluntary, and additional benefits are included.

• Perks for physical, mental, emotional, and financial wellbeing.

• Opportunities for professional growth and development.

• Emphasis on total health and wellness.

• Rewards and recognition programs.

• Fostering employee unity.

• Commitment to a tobacco-free workplace.