Manager, Clinical Care Services at Magellan Health Services inc in Maryland Heights, Missouri

Job 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.

• 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.

Other Job Requirements

Responsibilities

• 5 years post degree experience in a direct care clinical setting; managed care experience preferred.


• 1 year direct supervisory experience required.


• One or more of the following current, activelicenses are required: BCBA, LCSW, LMFT,LMSW, LPCC,LPC, PCor 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
Manager, Clinical Care Services

Grade
27

Work Experience
Clinical, Supervisory

Education
Associates: Nursing (Required), Masters: Behavioral Health (Required)

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

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.