Experienced Care Manager – Behavioral Health Treatment and Applied Behavior Analysis Services

Are you a compassionate and detail-oriented professional with a passion for delivering exceptional care to individuals with complex behavioral health needs? Do you thrive in a dynamic and collaborative environment where you can make a meaningful impact on the lives of others? If so, we invite you to join blithequark, a leading healthcare organization dedicated to providing innovative and patient-centered solutions. As a Care Manager at blithequark, you will play a vital role in overseeing and evaluating Behavioral Health Treatment (BHT) services, including Applied Behavior Analysis (ABA) services, for eligible members.Your expertise and dedication will ensure that our members receive the highest quality of care based on medical necessity, empowering them to achieve their full potential. Job OverviewJoin our esteemed healthcare organization as a Care Manager, where you will have the opportunity to make a significant impact on the lives of our members. In this vital role, you will navigate a mission-focused environment dedicated to excellence in member service and care management, demonstrating integrity and accountability.You will collaborate effectively with team members to fulfill departmental objectives and support both immediate and long-term goals. Key Responsibilities• Navigate a mission-focused environment dedicated to excellence in member service and care management, demonstrating integrity and accountability. • Collaborate effectively with team members to fulfill departmental objectives and support both immediate and long-term goals. • Assess requests for medical appropriateness and verify referrals according to established clinical guidelines.• Collect pertinent medical information for review by the Medical Director and communicate decisions clearly. • Accurately document all necessary information in the utilization management system, ensuring updates on authorizations are recorded. • Conduct thorough reviews of submitted documentation for compliance with coding (ICD-10, CPT-4, HCPCS) and coverage guidelines. • Maintain adherence to established policies and procedures while conducting quality reviews of documents. • Promptly notify providers and members of decisions made, ensuring timely and effective communication.• Stay updated on federal, state, and local regulations pertaining to the BHT benefit. • Identify potential quality concerns and report them as necessary, assisting with case audits when required. • Participate in additional projects and responsibilities as assigned. Required Skills• Establish and nurture strong relationships with colleagues and external partners from diverse backgrounds. • Work autonomously while exercising sound judgment in decision-making. • Communicate effectively in both verbal and written formats.• Adapt to a flexible work schedule that may include evenings and weekends. • Exhibit strong organizational, analytical, problem-solving, and project management skills. • Prosper in a fast-paced work environment while managing multiple tasks simultaneously. • Inspire and motivate team members and external committees. • Demonstrate proficiency in bolthires Office Suite (Word, Outlook, Excel, PowerPoint) and related applications. Qualifications• A Master’s degree in psychology, social work, counseling, or a related field, along with a minimum of four years of experience in providing ABA or mental health services, including clinical review and treatment plan oversight.• Current, unrestricted California license (LCSW, LPCC, LMFT, RN with BH experience, BCBA, or BCBA-D). Career Growth OpportunitiesOur organization values your professional development and offers numerous opportunities for skill enhancement and career advancement within the healthcare sector. You will have the chance to collaborate with a dedicated team, enhancing your professional network and skillset in the healthcare community. Company Culture and ValuesWe foster a collaborative environment that emphasizes high-quality performance and member service, nurturing a culture of dignity and respect.Our organization is committed to providing a supportive and inclusive work environment that encourages open communication, creativity, and innovation. Networking andProfessional OpportunitiesIn this role, you will have the chance to collaborate with a dedicated team, enhancing your professional network and skillset in the healthcare community. You will also have access to ongoing training and development opportunities, ensuring you stay up-to-date with the latest industry trends and best practices.Compensation and Benefits• Competitive salary commensurate with experience. • Comprehensive health, dental, and vision insurance. • Retirement savings plan with company matching contributions. • Generous vacation and paid time off policies. Work EnvironmentAs a remote employee, you will have the flexibility to work from the comfort of your own home, while still being connected to our dynamic and collaborative team. You will have access to cutting-edge technology and tools, ensuring you can perform your job duties efficiently and effectively.If you are a motivated and compassionate professional with a passion for delivering exceptional care, we invite you to apply for this exciting opportunity. Please submit your resume and a cover letter outlining your experience and qualifications for this role. We look forward to hearing from you! Equal Employment Opportunityblithequark is an equal employment opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive and respectful work environment that values diversity, equity, and inclusion.Contact InformationFor more information about this opportunity, please contact our recruitment team at. We look forward to connecting with you!