Case Manager - Utilization Management

Description

Professional - Clinical
Req #: 57303

~ 20 Hours/week, Benefit Eligible Part-Time, Day shift ~

~ Remote within Maine or New Hampshire as there are requirements to be onsite based on business needs ~

Maine state licensure to practice as a Licensed Clinical Social Worker (LCSW), Licensed Clinical Professional Counselor (LCPC), Registered Nurse - Certified Nursing Specialist (RNCS), Advanced Registered Nurse Practitioner (ARNP) is required

Summary

The Case Manager - Behavioral HealthCare Program (BHCP) is a part of MaineHealth's ACO and this role provides mental health and substance abuse management services to members in ambulatory, inpatient, crisis, stabilization unit, outpatient and alternative care settings. This role ensures that patients receive quality clinical care and authorizes necessary services in appropriate and cost-effective settings. Prior utilization management experience is required.

This benefit eligible part-time position offers a few different scheduling options that we are happy to discuss during the interview process. Mondays will be required and Fridays are preferred.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

1. Education: RNCS, ARNP, LCSW, LCPC or PhD Degree required.
2. License/Certifications: Current applicable state(s) license in area of education required.
3. Experience: Three years (postgraduate) of clinical experience preferred.
4. Additional Skills/Requirements Required: N/A
5. Additional Skills/Requirements Preferred: N/A

About BHCP

The Behavioral HealthCare Program (BHCP) manages the mental health and substance use benefits for 165,000 members of several health insurance plans in Maine, New Hampshire, Vermont, New York and Pennsylvania. BHCP helps members access the most appropriate provider and level of care to meet their needs. BHCP is committed to quality service through local coordination and strong provider involvement.

Our partners include: Aetna/MaineHealth, US Family Health Plan at Martin's Point, Martin's Point Generations Advantage and Anthem/MaineHealth Medicare Advantage.

If you have questions about this role, please contact sarah.evan@mainehealth.org