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We are searching for remote Case Managers and Care Managers (UM/Triage) in CA for a highly regarded behavioral health plan. These are REMOTE work-from-home role, with a regular M-F schedule, full time, permanent, with benefits. UM Triage Care Managers receive an average of 1-2 calls per hour while Case Managers are responsible for the assessment, reassessment, care planning and coordination of care and services including ongoing monitoring of an appropriate and effective person-centered care plan, member education and care management. .
Requirements for the Case Manager and Care Managers:
  • Bachelor’s or Associates + California RN — OR Master’s degree with either: LCSW, LMFT, LPCC. All candidates must have active California licensure.
  • 5 years’ post degree experience in healthcare, behavioral health, psychiatric and/or substance abuse health care setting.
Responsibilities of the Case Manager – Behavioral Health:
  • Authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings.
  • Collects and analyzes utilization data.
  • Provides telephone triage on a que, crisis intervention and emergency authorizations as assigned.
  • Authorizations for services and creating provider lists that are sent out to members to help locate providers
  • Assists with discharge planning and care coordination. Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects. Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.
Responsibilities of the Care Manager UM/Triage
  • Authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings.
  • Collects and analyzes utilization data.
  • Provides telephone triage on a que: crisis intervention and emergency authorizations as assigned. Authorizations for services and creating provider lists that are sent out to members to help locate providers.
  • Team members receive an average of 1-2 calls per hour.
  • Assists with discharge planning and care coordination.
  • Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects.
  • Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness..

Occupational Category: 29-1140 Registered Nurses

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Application Instructions: Please apply using the form or send your resume to Debbie Winkelbauer.