Behavioral Health Care Manager I

Behavioral Health Care Manager I

LOCATION: This is a virtual eligible role. Indiana residency is required.

HOURS: General business hours, Monday through Friday - Eastern time zone.

This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Behavioral Health Care Manager I is responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.

Primary duties may include but are not limited to:

• Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract.
• Refers cases to Peer Reviewers as appropriate.
• Performs psychiatric and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources.

Required Qualifications

• Requires MA/MS in social work, counseling, or a related behavioral health field, or a degree in nursing, and minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background.
• Requires a current active unrestricted license, such as LCSW, LMHC, LMSW, LMFT, RN or Clinical Psychologist to practice as a health professional within the scope of licensure from the state of Indiana.

Preferred Qualifications

• Experience in multiple treatment settings (inpatient, outpatient, etc.) is preferred.
• Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.
• Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.