CFSP Manager I, Placement Transition
Elevance Health
Salary
💰 $58,440 - $93,500 per year
Job Level
JuniorMid-Level
Tech Stack
Unity
About the role
- Authorize and review utilization of mental health and substance abuse services in inpatient and/or outpatient settings
- Collect and analyze utilization data and perform concurrent reviews for inpatient/outpatient care
- Assist with discharge planning, develop discharge plans with providers and oversee implementation
- Provide telephone triage, crisis intervention and emergency authorizations as assigned
- Perform quality clinical reviews, educate and intervene to advance member care
- Provide information to members and providers about benefits, community resources, managed care programs, policies and criteria
- Interact with Physician Advisors on clinical and authorization questions
- Participate in quality improvement activities including data collection, tracking, and analysis
- Maintain active workload according to National Care Manager performance standards
- Participate in network development, provider recruitment, and advocate for patient treatment needs
Requirements
- Licensure required: CEAP, LMSW, LCSW, LSW, LPC or RN (must meet State, Commonwealth or customer-specific requirements)
- Associate degree in Nursing or Bachelor's/Master's in Social Work (education required/preferred as listed)
- Minimum 2 years post-degree experience in healthcare, behavioral health, psychiatric and/or substance abuse settings
- Strong organization, time management and communication skills
- Knowledge of utilization management procedures and mental health and substance abuse community resources and providers
- Knowledge and experience in inpatient and/or outpatient settings
- Knowledge of DSM V or most current diagnostic edition
- Ability to analyze utilization problems, plan and implement solutions to influence quality of care
