Care Manager, BH

Magellan Health

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

Posted 10/23/2026full-timeRemote • 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. Proficient in analyzing utilization data and implementing solutions to enhance quality of care while adhering to legal and regulatory standards.

Highest-signal resume keywords

Licensed Mental Health ProfessionalUtilization Management ProceduresCrisis InterventionDischarge PlanningKnowledge of DSM V

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Utilization Data AnalysisConcurrent ReviewsQuality Clinical ReviewsCare CoordinationTelephone Triage

Soft Skills

Strong Organization SkillsTime ManagementCommunication SkillsAdvocacy for PatientsProfessional Interaction

Certifications & Qualifications

CEAPLMSWLCSWLSWLPCRN

Industry Keywords

Mental Health ServicesSubstance Abuse ServicesInpatient CareOutpatient CareBehavioral Health

About the role

Key responsibilities & impact

Authorize and review utilization of mental health and substance abuse services in inpatient and 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
Participate in quality improvement projects and activities
Monitor levels of care to ensure 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 members and providers with information about benefits, community 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

Current license meeting State, Commonwealth, or customer-specific requirements
One or more required licensures: CEAP, LMSW, LCSW, LSW, LPC, or RN, with necessary degrees
Minimum 2 years of experience post degree in a healthcare, behavioral health, psychiatric, and/or substance abuse healthcare 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 settings
Knowledge of DSM V or the most current diagnostic edition
Ability to analyze utilization problems and implement solutions influencing quality of care
Required education options: Associate in Nursing, Bachelor's in Social Work, or Master's in Social Work
Ability to 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