Care Manager

4 meses atrás

Belém, Brasil Integrated Resources Inc. Tempo inteiro

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.

We’ve stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.

Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients’ success.

Job Description

Description:

  • Under general supervision, and in collaboration with other members of the clinical team, the selected candidate will authorize and collect and analyze 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 oversees their implementation.
  • Performs concurrent reviews for inpatient care and other levels of care as allowed by scope of practice and experience.
  • 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.
Qualifications
  • Department hours: 8am – 6pm. The selected candidate will work from 8:30am – 5pm.
  • License: LCPC, LCSW, LSW or RN.
  • Caseload: 20 calls/day.
  • Experience: At least 1 year of Managed Care experience AND Drug & Alcohol experience.
  • Community Resource Experience: Required.
  • Candidate must be comfortable working in a cubicle environment, typing and talking simultaneously, in a fast-paced environment, and navigating through multiple systems.
  • MUST be computer literate.
Additional Information

All your information will be kept confidential according to EEO guidelines.

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