Care Manager

Description:

• Under general supervision, and in collaboration with other members of the clinical team, the selected candidate will authorizes and

• Collects and analyzes utilization data. Assists with discharge planning and ambulatory follow up activity.

• Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects.

Duties:

• Monitors inpatient and intermediate 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.

• In conjunction with providers and facilities, develops discharge plans and oversee their implementation.

• Performs concurrent reviews for inpatient care and other levels of care as allowed by scope of practice and experience. P

• 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, and criteria.

• Interacts with Physician Advisors to discuss Clinical/authorization questions and concerns regarding specific cases.