Care Manager, Utilization Managment at Topeka

Job Description

Care Manager, Utilization Are balance and a healthy lifestyle important to you? If you are looking for a career opportunity that supports and promotes overall well-being, look no further! At New Directions Behavioral Health, we are dedicated to helping people find a healthy balance and improve health through positive change. We are searching for like-minded professionals to join our team of behavior change experts in our Topeka, Kansas office, located on the Kansas Blue Cross Blue Shield campus. New Directions is seeking a Care Manager I, Utilization in Topeka, KS to be responsible for providing utilization management, support and care management activities for New Directions members. This includes review activities, care management activities (including on-site reviews) and significant coordination with all departments within New Directions, facilities and providers to promote effective, efficient care for NDBH members. The Care Manager, Utilizations key responsibilities include: Provides utilization review activities for all levels of behavioral health care including inpatient, residential, partial hospitalization intensive outpatient and outpatient authorization requests with contacts to facilities and providers as needed to accomplish this task. Demonstrates clinical expertise in response to a variety of circumstances ranging from crisis intervention to routine business matters. Participates in clinical staffing. Presents clinical cases to staff and consulting providers upon request of supervisor. Completes appropriate documentation in clinical systems in compliance with regulatory and accreditation standards. Telephonically provides information to members and providers regarding mental health and substance abuse referrals, community treatment resources, and New Directions services, policies and procedures and criteria. Coordinates peer review with NDBH Physician consultants on clinical cases that are not meeting the medical necessity criteria. Documents discharge planning as provided by facility. Provides follow-up and support calls to members and providers as needed and as assigned by Manager/Supervisor. Adheres to New Directions Behavioral Health Mission Statement, Core Values, Code of Business Conduct, and Compliance Program. Complies with all Federal and applicable State laws and New Directions Behavioral Health Policies regarding, privacy, confidentiality, and security of health information, and other designated information.

Job Requirements

Current unrestricted KS and/or MO license to practice as a Masters Level Social Worker, Marriage and Family Therapist, Professional Counselor, Clinical Psychologist or RN. Experience with facility-based and/or outpatient psychiatric or chemical dependency treatment is required. Strong computer skills (Word and Excel) Ability to comprehend medical policy and criteria to clearly articulate health information Preferred Qualifications: Previous experience in Utilization Review If youre ready to join a team of professionals that are dedicated to making a difference, we want to hear from you! New Directions Behavioral Health is an Equal Opportunity Employer M/D/V/F. We offer a very competitive compensation and benefits package. For consideration, please apply on-line at www.ndbh.com/careers.
Country: USA, State: Kansas, City: Topeka, Company: New Directions Behavioral Health LLC.