Job Title: Remote Care Manager

Pay: $40 an hr | Bi-weekly

Job Type:

• Remote in California (Must live in California and be a resident there)

Shift Options:

• M–F, 8/8:30 AM–4:40/5 PM PST.

Remote Care Manager Overview:

• JOB DESCRIPTION: 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.

• Performs concurrent reviews for inpatient and/or outpatient care and other levels of care as allowed by scope of practice and experience. In conjunction with providers and facilities, develops discharge plans and oversee their implementation.

• Performs quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatment.

• 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 and authorization questions and concerns regarding specific cases.

• Participates in quality improvement activities, including data collection, tracking, and analysis.

• Maintains an active work load in accordance with National Care Manager performance standards.

• Works with community agencies as appropriate.

• Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.

• Participates in network development including identification and recruitment of quality providers as needed.

• Advocates for the patient to ensure treatment needs are met.

• Interacts with providers in a professional, respectful manner that facilitates the treatment process.

• Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements.

Remote Care Manager Qualifications:

• One or more of the following licensure is required for this role with necessary degrees: CEAP, LMSW, LCSW, LPC, 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.

• Clinical 2+ years CERTIFICATIONS: Must have one of the following: CEAP - Certified Employee Assistance Professional, LCSW - Licensed Clinical Social Worker, LMFT - Licensed Marriage and Family Therapist, LMSW - Licensed Master Social Worker, LPC - Licensed Professional Counselor, RN - Registered Nurse, State and/or Compact State Licensure EDUCATION: Dependent on Certification--Associates: Nursing, Bachelors: Social Work, Masters: Social Work (Required)

Remote Care Manager Benefits:

• Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance.
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates.

How to Apply:

If you are interested in this position, please apply OR submit your resume to:

Saw Hlaing | shlaing@alinestaffing.com | 412-790-5425