Care Manager, BH

Magellan Health

. Authorize and review utilization of mental health and substance abuse services in inpatient and/or outpatient care settings .

Posted 9/18/2026full-timeRemote • Pennsylvania • United StatesJuniorMid-Level💰 $64,285 - $102,855 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in mental health and substance abuse services, including utilization management, care coordination, and quality improvement. Proficient in analyzing utilization data and implementing solutions to enhance patient care in both inpatient and outpatient settings.

Highest-signal resume keywords

Licensed In PennsylvaniaUtilization Management ProceduresKnowledge Of DSM VExperience In Behavioral HealthCrisis Intervention

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Utilization Data AnalysisDischarge PlanningConcurrent ReviewsQuality Clinical ReviewsTelephone TriageEmergency AuthorizationsCare CoordinationPatient AdvocacyCommunity Treatment ResourcesMedical Necessity Criteria

Soft Skills

Strong Organization SkillsTime ManagementCommunication Skills

Certifications & Qualifications

CEAPLCSWLMFTLMSWLPCLSWRN State Licensure

Industry Keywords

Mental HealthSubstance AbuseInpatient CareOutpatient CareBehavioral HealthQuality ImprovementHealthcare CompliancePatient CareManaged Care ProgramsCommunity Agencies

About the role

Key responsibilities & impact

Authorize and review utilization of mental health and substance abuse services in inpatient and/or outpatient care settings
Collect and analyze utilization data
Assist with discharge planning and care coordination
Provide member assistance with mental health and substance abuse issues
Participate in quality improvement projects and activities, including data collection, tracking, and analysis
Monitor inpatient and/or outpatient level-of-care services for medical necessity and effectiveness
Provide telephone triage, crisis intervention, and emergency authorizations
Perform concurrent reviews for inpatient, outpatient, and other applicable levels of care
Develop discharge plans with providers and facilities and oversee implementation
Perform quality clinical reviews, educate stakeholders, and make interventions to advance member care
Provide information about benefits, community treatment resources, managed care programs, policies, procedures, and criteria
Interact with Physician Advisors regarding clinical and authorization questions
Maintain workload according to National Care Manager performance standards
Work with community agencies and propose alternative treatment plans when services do not meet medical necessity criteria
Participate in network development, including identifying and recruiting quality providers
Advocate for patients and interact professionally with providers

Requirements

What you’ll need

Must be licensed in Pennsylvania
Current license meeting State, Commonwealth or customer-specific requirements
One or more required licensure credentials: CEAP, LMSW, LCSW, LSW, LPC or RN, with necessary degrees
Minimum 2 years of 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 and implement solutions influencing quality of care
Required education: Associate in Nursing, Bachelor's in Social Work, or Master's in Social Work
Required licenses/certifications include CEAP, LCSW, LMFT, LMSW, LPC, LSW, or RN State and/or Compact State Licensure
Compliance with security responsibilities, applicable legal, regulatory, contractual requirements, and internal policies and procedures

Benefits

Comp & perks

Short-term incentives may be available
Comprehensive benefits package
Health, life, voluntary and other benefits and perks
Tobacco-free workplace