RN Job In Boston, Massachusetts
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WA - Vancouver
The Care Manager will be responsible for authorizing and reviewing utilization of mental health and substance use services provided in inpatient and intermediate care settings; assists with discharge planning and ambulatory follow up activity.
ABOUT THE POSITION
We are currently seeking a dynamic Care Manager to join our team at our office in to join our team at our office in Southwest Washington State.
The Care Manager will be responsible for authorizing and reviewing utilization of mental health and substance use services provided in inpatient and intermediate care settings; assists with discharge planning and ambulatory follow up activity provides member assistance with mental health and substance use issues, and participates in special utilization projects.
Location: Vancouver, WA , Camas, WA
- Performs telephonic care review and authorization determinations for prospective, concurrent and discharge review with psychiatric and substance use treatment facilities as assigned.
- Determines appropriate level of care related to mental health and substance use treatment for members based on Beacon medical necessity level of care criteria.
- Consults with Beacon Physician Advisors (PA) when requests for services do not meet medical necessity criteria.
- Interacts with Physician Advisors to discuss clinical/authorization questions, alternative treatment options and concerns regarding specific cases.
- Provides information to members and providers regarding mental health and substance use benefits and community treatment resources.
- Recommends and arrange discharge plans, aftercare referrals and community resources when members have an inpatient psychiatric admission.
- Consults with providers to assist members with transportation, employment and daily living needs as they relate to individualized care plans.
- Works closely with nurse care managers, discharge planners, peers as well as local, regional and national team members.
Education: Master's Degree or RN
Licensure: Have either a current, valid, unrestricted independent license in behavioral health or nursing (RN) and practice within the scope of their licensure in the state of Washington
Relevant Work Experience: Minimum of two (2) years of combined direct behavioral health clinical and managed care experience
Knowledge, Skills & Abilities:
- Demonstrated experience establishing relationships and effectively engaging with members and providers through telephonic communication to obtain necessary information and facilitate care in multiple settings.
- Demonstrated work experience to influence and negotiate to effectively manage patient care and health care outcomes.
- Demonstrated work experience meeting strict deadlines and established cycle times through effective prioritization and follow-up skills.
- Excellent communication skills, both verbal and written.
- Demonstrated ability to relate effectively to behavioral health and medical treatment providers, members and family member and other professionals involved in the treatment of the member.
- Familiarity with and ability to effectively utilize computer technology.
- Familiarity with motivational interviewing is preferred.
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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled
AAP Reporting Location:
ID (Req #):
Monday - Friday