We're looking for a Safety Net Behavioral Health Case Manager, working in the Insurance industry in Fairport, New York, United States.
Performs clinical review of the appropriateness and quality of behavioral health services, and applies guidelines and medical policies.
Performs a clinical assessment and coordinates care on all members referred from a behavioral health inpatient level of care and assists members in accessing the most appropriate level of care.
Plans, implements, and documents case management activities which incorporate a thorough understanding of clinical knowledge, members specific health plan benefits, and efficient care delivery processes.
Identifies and refers potential quality of care and utilization issues to Health Plan Medical Director.
Utilizes appropriate communication techniques with members and providers to obtain behavioral health information, assesses need for continuation of services, assists members in obtaining needed services, as appropriate, and interacts with the treating physician or other providers of care.
The pay range we're offering is 33 per hour. This position may present an opportunity to go permanent.
Our client is a fast-growing industry-recognized staffing firm. Recruiting critical IT, Financial, Engineering, Healthcare, and Data Analytics talent. With 20+ years’ experience and growth.
Connections in Automotive, Healthcare, Retail, Financial & Insurance, and Professional & Business Services. Working to bring top talent together with premier organizations.
Big enough to have great opportunities. Small enough to care about finding the right one for you.
It’s about relationships based on mutual interest. The results are low turnover, long-lasting partnerships and growth. Want to work for a company invested in your success?
Experience Required for Your Success
RN with current New York State license (BSN Preferred), a New York State licensed Social Worker (LMSW), or a New York State certified Alcohol and Substance Abuse Counselor
3 years of clinical experience (community health, behavioral health, and managed care experience)
Experience in interpreting health plan benefit plans
Knowledge of Medicaid guidelines
Understanding and works accordingly in order to meet the highest quality standards
Demonstrated work habits sufficient to be able to work independently on a daily basis
Ability to consistently meet case load assignments
Ability to maintain consistent positive results on monthly case audits
Ability to travel
What Do You Think?
Does your experience reflect what it takes to be successful in this role? Do the work and challenges get you excited about what's possible? Apply here.