The BH Care Manager I manages psychiatric and substance abuse disorder facility-based and outpatient treatment benefits through telephonic or written review
Uses screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary behavioral healthcare in a cost-effective setting per UM Guidelines and contract
Refers cases to Peer Reviewers as appropriate
Performs psychiatric and substance abuse assessment, coordination, implementation, case planning, monitoring and evaluating to promote quality member outcomes and to promote effective use of health benefits and community resources
Requirements
Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background
Current, active, unrestricted license, such as RN (must have exp. in behavioral health), LCSW, LMHC, LPC, or LMFT to practice as a health professional within the scope of licensure in Indiana; licensure is a requirement