Care Manager, BH

Magellan Health

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

Posted 9/15/2026full-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 crisis intervention. Possesses strong analytical skills to assess utilization data and develop effective discharge plans while ensuring compliance with legal and regulatory standards.

Highest-signal resume keywords

PA Licensed Behavioral Health ProfessionalExperience With Intensive Behavioral Health ServicesKnowledge Of Utilization Management ProceduresStrong Organization And Time Management SkillsKnowledge Of DSM V

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Utilization Data AnalysisCrisis InterventionDischarge PlanningConcurrent ReviewsQuality Clinical ReviewsBehavioral Health ServicesMental Health AssessmentCare CoordinationEmergency AuthorizationsPatient Advocacy

Soft Skills

Communication SkillsInterpersonal SkillsOrganizational SkillsTime Management Skills

Certifications & Qualifications

CEAPLMSWLCSWLSWLPCRN

Industry Keywords

Mental HealthSubstance AbuseInpatient CareOutpatient CareCommunity Treatment ResourcesManaged Care ProgramsQuality Improvement ActivitiesBehavioral HealthPsychiatric CareLegal And Regulatory Compliance

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 for mental health and substance abuse issues
Monitor levels of care to ensure medical necessity and effectiveness
Provide telephone triage, crisis intervention, and emergency authorizations
Perform concurrent reviews for inpatient and/or outpatient care and other levels of care within scope of practice and experience
Develop discharge plans with providers and facilities and oversee implementation
Perform quality clinical reviews, educate stakeholders, and intervene to advance member care
Provide information about benefits, community treatment resources, managed care programs, company policies, procedures, and criteria
Interact with Physician Advisors regarding clinical and authorization questions
Participate in quality improvement activities, including data collection, tracking, and analysis
Maintain an active 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 to facilitate treatment

Requirements

What you’ll need

PA licensed behavioral health professional
Experience working with children and adolescents
Experience with Intensive Behavioral Health Services levels of care, BHRS, and/or ABA preferable
Current license meeting State, Commonwealth or customer-specific requirements
One or more required licenses: 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
Knowledge of 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
Education required: Associate - Nursing, Bachelor's - Social Work, or Master's - Social Work
Must comply with applicable legal, regulatory, contractual, security, and internal policy requirements

Benefits

Comp & perks

Short-term incentives may be available
Comprehensive benefits package
Health, life, voluntary and other benefits
Benefits and perks supporting physical, mental, emotional and financial wellbeing
Tobacco-free workplace
Equal Opportunity Employer