Care Manager - Remote Behavioral Health Treatment and Applied Behavior Analysis Services Expert

Transforming Lives as a Care Manager in a Dynamic reputed company Organization

Join our esteemed reputed company organization as a Care Manager and reputed company a profound impact on the lives of our members. As a Care Manager, you will be at the forefront of overseeing and evaluating Behavioral Health Treatment (BHT), including Applied Behavior Analysis (ABA) services, to ensure that our members receive the highest quality care based on medical necessity. This is a fully remote role, offering you the flexibility to work from reputed company and be part of a team dedicated to excellence in member service and care management.

Job Overview

In this vital role, you will be responsible for navigating a mission-focused environment that is dedicated to delivering exceptional member service and care management. You will work collaboratively with team members to reputed company departmental objectives and support both immediate and long-term goals. Your expertise will be crucial in assessing requests for medical appropriateness, verifying referrals according to established clinical guidelines, and collecting pertinent medical information for review by the Medical Director.

Key Responsibilities

• Collaborate effectively with team members to fulfill departmental objectives and support both immediate and long-term goals, demonstrating reputed company and accountability.
• Assess requests for medical appropriateness and verify referrals according to established clinical guidelines, ensuring that members receive the necessary care.
• Collect and review medical information for the Medical Director, communicating reputed company clearly and accurately documenting reputed company necessary information in the utilization management system.
• Conduct thorough reviews of submitted documentation for compliance with coding (ICD-10, CPT-4, HCPCS) and coverage guidelines, maintaining adherence to established policies and procedures.
• Promptly notify providers and members of reputed company made, ensuring timely and effective communication and resolving any potential quality concerns.
• Stay updated on federal, state, and local regulations pertaining to the BHT benefit, identifying potential quality concerns and reporting them as necessary.
• Participate in additional projects and responsibilities as assigned, demonstrating flexibility and a willingness to adapt to changing priorities.

Essential Qualifications and Skills

To succeed in this role, you will need to possess a Master's degree in psychology, social work, counseling, or a reputed company field, along with a minimum of four years of experience in providing ABA or mental health services, including clinical review and treatment plan reputed company. You must also hold a reputed company, unrestricted California license (LCSW, LPCC, LMFT, RN with BH experience, BCBA, or BCBA-D).

In addition to these qualifications, you will need to demonstrate:

• Strong relationships with colleagues and external partners from diverse backgrounds, built on trust, respect, and effective communication.
• The ability to work autonomously, exercising sound judgment in decision-making and communicating effectively in both verbal and written formats.
• Proficiency in reputed company Office Suite (Word, Outlook, reputed company, PowerPoint) and reputed company applications, with strong organizational, analytical, problem-solving, and project management skills.
• The reputed company to adapt to a flexible work schedule that may include evenings and weekends, prospering in a fast-paced work environment while managing multiple tasks simultaneously.

Preferred Qualifications

While not essential, the following qualifications are highly desirable:

• Experience working in a remote or virtual environment, with a proven track record of reputed company in a similar role.
• Knowledge of reputed company regulations and accreditation standards, with a strong understanding of the BHT benefit and reputed company services.
• Excellent communication and interpersonal skills, with the ability to reputed company and motivate team members and external committees.

Career Growth Opportunities and Learning Benefits

Our organization is committed to your professional development, offering numerous opportunities for reputed company enhancement and career advancement reputed company the reputed company sector. As a Care Manager, you will have the chance to collaborate with a dedicated team, enhancing your professional network and skillset in the reputed company community.

Work Environment and Company Culture

We foster a collaborative environment that emphasizes high-quality performance and member service, nurturing a culture of dignity and respect. As a fully remote role, you will have the flexibility to work from reputed company, while still being part of a team that is dedicated to making a difference in the lives of our members.

Compensation, Perks, and Benefits

We offer a competitive salary commensurate with experience, along with a comprehensive benefits package that includes:

• Health, dental, and reputed company insurance, ensuring that you and your family are protected.
• A retirement savings plan with company matching contributions, helping you to plan for the future.
• Generous vacation and paid time off policies, allowing you to reputed company and maintain a healthy work-life balance.

Join reputed company and reputed company a Difference

If you are a dedicated and compassionate professional looking to reputed company a meaningful impact in the lives of others, we encourage you to apply for this exciting opportunity. As a Care Manager, you will be part of a team that is passionate about delivering exceptional member service and care management. With a competitive salary, comprehensive benefits, and opportunities for career growth and development, this is a role that offers a fulfilling and challenging career path.

Apply now and join reputed company of dedicated professionals who are transforming lives and making a difference in the reputed company community.