- Assists clinical management in the development and on-going management of designated staff.
- Performs care management review activities consistent with Magellan policies, procedures, and standards.
- Conducts recruitment, interviewing, and selection of properly qualified staff members and ensures appropriate orientation is provided.
- Regularly monitors the performance of care management staff. Monitors adherence to the efficiency goals for all staff including case volume, case closure rates, average handle time and other metrics.
- Supervises care management staff through approved audit processes including performing annual reviews and provides counseling and disciplinary action as necessary.
- Coordinates quality improvement activities under the direction of clinical management.
- Assists management in the development of strategic and operational goals and plans.
- Assists management in the identification and coordination of the necessary clinical and client service training needs.
- Analyzes specific utilization problems, plans and implements solutions that directly influence quality of care and cost efficiency.
- Supervises the collection of pertinent clinical information while maintaining a good rapport and relationship with providers.
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Mgr, Clinical Care Services - Albuquerque, United States - Magellan Health
Description
Responsible for the management, direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management and intensive care management staff, providing expertise in designated programs.
Responsibilities
5 years post degree experience in a direct care clinical setting; managed care experience preferred.
One or more of the following current, active licenses are required: BCBA, LCSW, LMFT, LMSW, LPCC, LPC, PC or RN.
If RN, BSN preferred but ASN considered with additional experience.
Thorough knowledge of physical, medical specialty and/or mental health community resources and providers.
Thorough knowledge of healthcare services in physical health, behavioral health or other medical specialty area based on pod management.
Considerable skill in interpreting clinical treatment information and making appropriate referral and triage decisions.
Must meet Magellan's credentialing criteria for RN, Masters or Doctoral level provider.
General Job Information
Title
Mgr, Clinical Care Services
Grade
27
Work Experience - Required
Clinical
Work Experience - Preferred
Education - Required
Associate - Nursing, Master's - Behavioral Health
Education - Preferred
Bachelor's - Nursing
License and Certifications - Required
BCBA - Board Certified Behavior Analyst - Care Mgmt, Current licensure required for this position that meets State, Commonwealth or customer-specific requirements - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LMHC - Licensed Mental Health Counselor - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPCC - Licensed Professional Clinical Counselor - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, PC - Professional Counselor - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt
License and Certifications - Preferred
Salary Range
Salary Minimum:
$77,785
Salary Maximum:
$124,455
This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
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