Care Manager

MHN (a Health Net company) is a leading national provider of managed behavioral health care and Employee Assistance Programs (EAPs). It provides employers and employees with mental health support, chemical dependency treatment and disability management. Among MHN's comprehensive suite of services are face-to-face counseling, telephonic support, critical incident stress debriefings and a full suite of online resources.







Responsibilities:







Make medical necessity determinations and refer to appropriate level of care utilizing the MHN LOC guidelines

  Performs telephonic, clinical assessment to determine immediate clinical needs of members and to arrange emergent/urgent services as needed

Authorize inpatient , alternative and/or outpatient treatment according to benefit plan and limitations

Clearly and completely documents all initial ,concurrent and discharge reviews, including, but not limited to, diagnosis, symptoms, interventions, goals and plan for next review and/or after care

Close all cases according to the defined case closure procedure and in accordance with guidelines established by MHN

Participate in training of other Care Managers as necessary

Perform Risk Management Activities as needed

Maintains confidentiality of member specific date

Attend Administrative and Clinical meetings

Perform special audits, projects, etc. as required
REQUIREMENTS


Qualifications:







Master's degree in social work, or RN with 3-5 years experience in psychiatric nursing, or Ph.D. in psychology and NY clinical licensure

Minimum of 3 years post-masters degree experience, preferably inpatient or alternate care, mental health and substance abuse

Ability to triage, assess and refer to all levels of care

Knowledge of commercial/or managed care principles and practices preferred

Understanding of basic computer keyboard operations; good typing skills

Effective and professional communication both in writing and telephonically