Website New Directions Behavioral Health
CARE MANAGER, AFTER HOURS
Location: Remote Work From Home
Job Code: 853
# of openings: 1
New Directions is growing and we are seeking a Care Manager, After Hours to join our team. The Care Manager, After Hours will work remotely from home. The Care Manager, After Hours will be responsible for handling initial mental health telephone contacts from insured, EAP, uninsured callers, and providers. The Care Manager conducts clinical telephonic focused screenings, clinical precertification for appropriate level of care, promotes care transitions activities for members being discharged from higher levels of care, review out and provides telephonic crisis intervention. Once initial training is completed, these Care Managers will work remotely from home.
Performance is measured against both individualized and job specific annual performance evaluation goals, which may include the following: availability to answer phone calls, assisting members with health plan and EAP referrals, appropriate application of medical necessity criteria during utilization review process. These measures will be assessed and reevaluated continuously throughout the year.
After Hours schedule for this position is:
Every other Wednesday, every Thursday, Friday and Saturday – 10:00 A.M to 10:00 P.M. CST
The Care Manager, After Hours Key Responsibilities include:
- Demonstrates a professional knowledge of mental health diagnosis and treatment modalities in a managed care and/or EAP context.
- Demonstrates knowledge of the range of mental health and EAP benefits provided by member’s insurance.
- Provides utilization review activities during established times for behavioral health care authorization requests with contacts to facilities and providers as needed to accomplish this task
- Promotes and provides effective and quality service delivery for optimal member health outcomes
- Coordinates peer review on clinical cases that are not meeting the medical necessity criteria
- Provides clinical expertise in response to a variety of circumstances ranging from crisis intervention to routine business matters
- Utilizes appropriate and standardized tools including but not limited to NDBH approved precertification, physician review tools, authorization screen, and other application and tools
- Completes appropriate documentation in clinical systems in compliance with regulatory and accreditation standards
- Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and New Directions services, policies and procedures and criteria
- Coordinates consultations with member’s provider, family and NDBH Physician consultants on clinical cases when necessary and appropriate to facilitate care and progress
- Stays current with New Directions’ technology, member Behavioral Health benefits, and non-health community resources
- Provides follow-up and support calls to members and providers as needed and as assigned by Manager/Supervisor
- Demonstrates the initiative, self-organizational skills, self-discipline, and competence to work remotely from a home office.
- Has a home based office that provides an environment conducive to completing assigned job responsibilities and meets the standards outlined under the New Directions telecommuting policy
- Is flexible and willing to provide assistance to co-workers when needed in urgent or routine situation Covers assigned hours/shifts and has the ability to cover other shifts as assigned by department director, manager, or designee and serves on the department clinical on-call rotation as mandatory
- Participates in on-going continuing education as required by professional licensure, certification, or as requested by New Directions and maintains required clinical licensure and certifications
- Participates in special committees or projects for program development as assigned by the Manager/Supervisor
- Attends on site staff meetings, required professional trainings, New Directions all staff meetings, after-hours staff meetings
- Participates in group peer process in which difficult cases are presented where interventions are validated as appropriate as well as suggestions for change and problem solving occurs
- Adheres to the policies and procedures for Utilization Management activities as well as screening, triage and referral activities, including timeliness of activities/services and accuracy of documentation
- Adheres to Professional Codes of Ethics as determined by professional licensure, certification and company policy
- Has a current, unrestricted license issued by a state or territory of the United States to practice independently as a Clinical Social Worker, Marriage and Family Therapist, Professional Counselor, Clinical Psychologist or Registered Nurse in the state in which the business operation is located and/or other states as required by law, regulation or contract.
- Minimum of 3-5 years of direct clinical care experience with patients in facility-based and/or outpatient psychiatric or chemical dependency treatment
- Strong clinical skills
- Excellent verbal and written communication and interpersonal skills
- Strong computer and keyboarding skills (Microsoft Outlook and Word), including the ability to document while simultaneously while taking information over the phone
- Minimum of five (5) years post-licensure experience in direct clinical care with patients in facility-based and/or outpatient psychiatric or chemical dependence treatment
- For Registered Nurses, a Bachelor’s Degree in Nursing
- Previous EAP experience, CEAP certification
- Minimum of two (2) years’ experience in a managed care environment.
- Minimum of two (2) years’ experience in crisis intervention work, in-service and professional training experience
- Previous experience in Utilization Review
- Experience and training in Motivational Interviewing
New Directions Behavioral Health is an Equal Opportunity Employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, protected veteran status, gender identity, sexual orientation or any other characteristic protected by law.
We offer a very competitive compensation and benefits package.
For consideration, please apply on-line at www.ndbh.com