Care Manager - BH (Onsite, Hollidaysburg, PA)

Location: Onsite in Hollidaysburg, Pennsylvania, United States

Salary: $64,285–$102,855 annually

Company

hirify.global provides healthcare and behavioral health management services.

What you will do

• Authorize and review the medical necessity, effectiveness, and level of care for inpatient and outpatient mental health and substance abuse services.
• Perform concurrent clinical reviews, telephone triage, crisis intervention, and emergency authorizations within the scope of practice.
• Develop discharge plans with providers and facilities and oversee their implementation.
• Provide members and providers with information about behavioral health benefits, treatment resources, managed care programs, and applicable criteria.
• Analyze utilization data, participate in quality improvement projects, and propose alternative treatment plans when services do not meet medical necessity criteria.
• Coordinate with Physician Advisors, community agencies, and behavioral health providers while advocating for members’ treatment needs.

Requirements

• Current state, Commonwealth, or customer-specific licensure is required.
• One or more of the following licenses or credentials: CEAP, LMSW, LCSW, LMFT, LPC, LSW, or RN with state or compact-state licensure.
• Associate degree in Nursing, bachelor’s degree in Social Work, or master’s degree in Social Work.
• At least two years of post-degree experience in healthcare, behavioral health, psychiatric, or substance abuse care.
• Knowledge of utilization management procedures, behavioral health resources, inpatient and outpatient care, and the DSM-5 or current diagnostic edition.
• Strong organization, time management, communication, analytical, and problem-solving skills.

Nice to have

• Experience working with maternity populations.

Culture & Benefits

• Short-term incentive eligibility may be available.
• Comprehensive health, life, voluntary, and other benefits and perks are offered.
• Tobacco-free workplace.
• Equal opportunity employment workplace.