Case Manager - Remote at DIVERSANT, LLC

Diversant has an immediate need for a talented Case Manager that will bring their experience to our client in the Managed Healthcare Industry. This is a 6-month contract opportunity with potential to convert to full-time and will sit remotely in CA.  We are currently interviewing to fill this and other similar contract positions. Qualified candidates should apply NOW for immediate consideration
 
Job Title:  Case Manager
Location: Remote in California
Duration: 6 months with conversion potential
Pay Rate:  $40.00 hr. W2
JOB DESCRIPTION:

• Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.
• Provides telephone triage, crisis intervention and emergency authorizations as assigned.
• Performs concurrent reviews for inpatient and/or outpatient care and other levels of care as allowed by scope of practice and experience.
• In conjunction with providers and facilities, develops discharge plans and oversee their implementation.
• Performs quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatment.
• Provides 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, and criteria. Interacts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.
• Participates in quality improvement activities, including data collection, tracking, and analysis. Maintains an active workload in accordance with National Care Manager performance standards. Works with community agencies as appropriate.
• Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.
• Participates in network development including identification and recruitment of quality providers as needed. Advocates for the patient to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process.

RESPONSIBILITIES:

• Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements. 
• One or more of the following licensure is required for this role with necessary degrees: 
  • LMSW, LCSW, LPC, RN or LPN.
• Minimum 2 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care setting.
• Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community resources and providers.
• Knowledge and experience in inpatient and/or outpatient setting.
• Knowledge of DSM V or most current diagnostic edition. Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care.

WORK EXPERIENCE:

• Clinical 2+ years

CERTIFICATIONS
 Must have one of the following:

• LCSW - Licensed Clinical Social Worker, LMFT - Licensed Marriage and Family Therapist, LMSW - Licensed Master Social Worker, LPC - Licensed Professional Counselor, LPN - Licensed Practical Nurse, RN - Registered Nurse, State and/or Compact State Licensure

EDUCATION: Dependent on Certification--Associates: Nursing, Bachelors: Social Work, Masters: Social Work (Required)