Magellan Health

Compensation

Full Description

Description: • Authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings. • Collects and analyzes utilization data. • Assists with discharge planning and care coordination. • Provides member assistance with mental health and substance abuse issues. • Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness. • Provides telephone triage, crisis intervention, and emergency authorizations as assigned. • Develops discharge plans and oversees their implementation in conjunction with providers and facilities. • Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures. Requirements: • Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements. • One or more of the following licensure is required for this role with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN. • Minimum 2 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care setting. • Strong organization, time management and communication skills. • Knowledge of utilization management procedures, mental health and substance abuse community resources and providers. • Knowledge and experience in inpatient and/or outpatient setting. • Knowledge of DSM V or most current diagnostic edition. • Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care. Benefits: • comprehensive benefits package • health, life, and voluntary benefits • wellness programs