Magellan Health

Counselor

• Provide direct support to organizations and employees through assessment, consultation, education and triage services
• Use knowledge of federal regulations to assist organizations with employee concerns and problems
• Consult with employees and organizations on workplace and work-based issues
• Provide clinical expertise to restore employees with diminished performance to healthy functioning
• Provide employee and management consultation on personal, workplace and management problems and concerns
• Conduct critical incident response services, EAP assessment and short-term counseling
• Deliver EAP orientations, customer webinars, critical incident response, and health and wellness trainings
• Manage caseload and complete timely case documentation
• Provide information and referrals to appropriate levels of care and community resources
• Participate in activities that improve SBU and/or client performance, excellence and culture
• Identify operational challenges or inefficiencies and recommend continuous improvement plans
• Analyze and present issues clearly, concisely and persuasively, verbally and in writing
• Develop effective working relationships across organizational lines and support team activities and trainings
• Maintain professional development and current skills and techniques
• Adhere to contract requirements, performance standards, meetings, trainings, standard operating procedures and company policies
• Perform other duties as assigned

Part-Time EAP Counselor

Manager

• 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

Care Manager, BH

Customer Support

• Assist in the physician advisor process for cases sent for peer-to-peer review
• Support scheduling of reviews, communicating results, and completing verbal and written correspondence
• Research cases referred to peer review and contact facilities to schedule physician-to-physician reviews
• Document task completion in applicable internal systems
• Prepare administrative, approval, and clinical denial letters
• Review completed denial letters for accuracy, template use, and appropriate grade level
• Take calls from the designated phone queue when needed
• Identify risk situations and escalate them to the supervisor
• Troubleshoot case issues by coordinating with internal departments, team members, and physicians
• Consult internal departments to ensure cases meet guidelines
• Assist in mentoring and training new UM Support Specialists
• Perform additional duties assigned by a leader consistent with the job's intent

Part-Time EAP Counselor

Care Manager, BH

Utilization Management Support Specialist I