Care Manager

Há 6 dias

Belém, Pará, Brasil Integrated Resources Inc. Tempo inteiro

About the Role:

Integrated Resources, Inc. is seeking a highly skilled Care Manager to join our team. As a Care Manager, you will play a critical role in ensuring the delivery of high-quality, patient-centered care to our members.

Key Responsibilities:

  • Authorize and collect and analyze utilization data to ensure medical necessity and effectiveness of inpatient and intermediate level of care services related to mental health and substance abuse treatment.
  • Assist with discharge planning and ambulatory follow-up activity to ensure seamless transitions of care.
  • Provide member assistance with mental health and substance abuse issues, and participate in special quality improvement projects to drive continuous improvement.
  • Monitor inpatient and intermediate level of care services to ensure compliance with company policies and procedures.
  • Develop and implement discharge plans in conjunction with providers and facilities.
  • Perform concurrent reviews for inpatient care and other levels of care as allowed by scope of practice and experience.
  • Provide 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.
  • Interact with Physician Advisors to discuss clinical/authorization questions and concerns regarding specific cases.

Requirements:

  • LCPC, LCSW, LSW, or RN licensure.
  • At least 1 year of Managed Care experience and Drug & Alcohol experience.
  • Community Resource Experience required.
  • Ability to work in a fast-paced environment, navigating through multiple systems.
  • Computer literacy required.

About Integrated Resources, Inc.:

Integrated Resources, Inc. is a leading provider of strategic workforce solutions. Our team of experts delivers tailored approaches to meet the unique needs of our clients, aligning skills and cultures to drive success.

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