Behavioral Care Mgr

Job Description

Position Purpose: Authorize and/or review utilization of mental health and substance abuse services provided in inpatient and intermediate care settings. Assure appropriate levels of care and medical necessity in a manner that supports the recovery process
Identify placement settings that offer the lowest level of restriction and greatest level of autonomy for the members based upon medical necessity
Monitor quality of care and collect and analyze utilization data
Serve as a resource and liaison between the health plan, behavioral providers, facilities, member and families
Provide and/or review member intakes and initial evaluations
Comply with performance measures in regards to denials, higher level of care admission certifications and concurrent review timeliness
Develop and maintain collaborative relationships with providers and educate on levels of care
Interact with physicians, social workers, providers, case managers, and family members to develop discharge plans and oversee their implementation