Care Manager – Remote Jobs California

Job Type: Care Manager from home
Location: California work from home
Company: Magellan Health

The major goals of this role are to lessen the personal and professional costs connected to emotional health problems, help maintain a safe workplace, and serve as a concrete example of the company’s compassion for its workers. Effective and caring services are given to help employees recover from poor professional performance and support the well-being of their families by dealing with them with behavioral and emotional health difficulties, substance misuse, and other personal matters.

Responsibilities:

• Offers knowledgeable advice to staff members and/or managers with a range of work-related and workplace difficulties.
• Offers advice to employees on particular personal issues and situations.
• Information is given, and as necessary, community resources are recommended.
• Assesses the crisis and offers intervention as necessary.
• Completes necessary forms and clinical and administrative documents clearly and succinctly.
• Maintains clinical and administrative records in compliance with approved protocols.

Authorizes and reviews the use of mental health and drug abuse services offered in inpatient and/or outpatient care settings under general supervision and in coordination with other clinical team members. gathers and examines use statistics. helps with care coordination and discharge planning. assists members with their mental health and drug misuse difficulties and takes part in unique quality improvement initiatives.

• Ensures the medical need and efficacy of inpatient and/or outpatient level of care services connected to mental health and drug misuse treatment.
• Provides crisis intervention, emergency authorizations, and telephone triage as needed.
• Concurrent reviews are carried out for inpatient, outpatient, and other levels of treatment as permitted by the practice area and experience.
• Develops discharge plans and manages their execution in collaboration with facilities and providers.
• Performs high-quality clinical reviews while educating and providing the member with the necessary interventions to advance their care.
• Provides members and providers with information on benefits for mental health and substance misuse, local resources for treatment, mental health managed care programs, and corporate rules, procedures, and standards.
• Talks with physician advisors for clinical and authorization issues pertaining to particular instances.
• Participates in efforts aimed at improving quality, such as gathering, monitoring, and analyzing data.
• Maintains an active workload in compliance with the performance standards for National Care Managers.
• Works as necessary with neighborhood organizations. when service requests do not adhere to the standards for medical necessity, suggests alternate treatment methods.
• Takes part in network development, which includes locating and hiring qualified providers as needed.
• ensures that the patient’s needs are addressed in terms of treatment. Has respectful and professional interactions with clinicians that help the therapeutic process.

Requirements:

• A current license that satisfies the standards of the State, Commonwealth, or the client is necessary for this position.
• For this position, you must have at least one of the following licenses with the requisite degrees: CEAP, LMSW, LCSW, LSW, LPC, or RN.
• A minimum of two years of experience following graduation in a setting providing medical care, behavioral health, psychiatric, and/or drug misuse treatment.
• Strong time-management, communication, and organizing abilities.
• Understanding of usage management practices, local providers and services for mental health and substance misuse.
• Understanding and practical experience in a hospital or outpatient context.
• Knowledge of the most recent diagnostic edition or DSM V.
• Being able to create and implement solutions that have a direct impact on care quality after carefully analyzing individual utilization issues.