Care Manager, BH - Remote PA
Magellan Health · Bethlehem, PA · 1 mo ago
Administrative$64k/yrFull-time
We need to output HTML fragment with headings for sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. We must not repeat job title as heading. No Job ID etc. Remove boilerplate. Must preserve all substantive info.
We need to parse the posting.
Key content:
- Remote position, candidate needs to be licensed in PA.
- Under general supervision, collaborates with clinical team, authorizes and reviews utilization of mental health and substance abuse services in inpatient/outpatient.
- Collects and analyzes utilization data.
- Assists with discharge planning and care coordination.
- Provides member assistance with mental health and substance abuse issues, participates in special quality improvement projects.
- Monitors inpatient/outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.
- Provides telephone triage, crisis intervention and emergency authorizations as assigned.
- Performs concurrent reviews for inpatient/outpatient care and other levels of care as allowed by scope of practice and experience.
- In conjunction with providers and facilities, develops discharge plans and oversee their implementation.
- Performs quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatment.
- Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.
- Interacts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.
- Participates in quality improvement activities, including data collection, tracking, and analysis.
- Maintains an active work load in accordance with National Care Manager performance standards.
- Works with community agencies as appropriate.
- Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.
- Participates in network development including identification and recruitment of quality providers as needed.
- Advocates for the patient to ensure treatment needs are met.
- Interacts with providers in a professional, respectful manner that facilitates the treatment process.
- The job duties listed above are representative and not intended to be all-inclusive... (we can keep but it's generic; maybe we can keep as part of responsibilities but it's not substantive? It's a note; we could keep but it's not adding new info; but we can keep as part of responsibilities.)
Then "Responsibilities Other Job Requirements" heading appears but we need to parse.
After that: "Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements. One or more of the following licensure is required for this role with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN. Minimum 2 years 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, plan and implement solutions that directly influence quality of care."
Then "General Job Information Title Care Manager, BH - Remote PA Grade 25 Work Experience - Required Clinical Work Experience - Preferred Education - Required Associate - Nursing, Bachelor's - Social Work, Master's - Social Work Education - Preferred License and Certifications - Required CEAP - Certified Employee Assistance Professional - Care MgmtCare MgmtCare Mgmt, LCSW - Licensed Clinical Social Worker - Care MgmtCare MgmtCare Mgmt, LMFT - Licensed Marital and Family Therapist - Care MgmtCare MgmtCare Mgmt, LMSW - Licensed Master Social Worker - Care MgmtCare MgmtCare Mgmt, LPC - Licensed Professional Counselor - Care MgmtCare MgmtCare Mgmt, LSW - Licensed Social Worker - Care MgmtCare MgmtCare Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare MgmtCare Mgmt License And Certifications - Preferred Salary Range Salary Minimum $64,285 Salary Maximum $102,855 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing."
Then EEO etc which we remove.
We need to structure into sections: About the role (maybe a brief summary), Responsibilities (list of duties), Requirements (licensure, experience), Qualifications (education, etc), Skills (organization, time management, communication, knowledge...), Benefits (benefits package mention), Pay (salary range), Schedule (maybe remote? Not explicit schedule; but we have remote; schedule not given; we should not create Schedule section unless posting actually states it. It does not mention schedule specifics, so we should not include Schedule.)
We need to decide which sections to include based on content.
We have:
- About the role: Could be a paragraph summarizing the role: remote, licensed in PA, under supervision, etc. We have that content.
- Responsibilities: list of duties (the bullet-like sentences). We'll put
for sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. We must not repeat job title as heading. No Job ID etc. Remove boilerplate. Must preserve all substantive info.
We need to parse the posting.
Key content:
- Remote position, candidate needs to be licensed in PA.
- Under general supervision, collaborates with clinical team, authorizes and reviews utilization of mental health and substance abuse services in inpatient/outpatient.
- Collects and analyzes utilization data.
- Assists with discharge planning and care coordination.
- Provides member assistance with mental health and substance abuse issues, participates in special quality improvement projects.
- Monitors inpatient/outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.
- Provides telephone triage, crisis intervention and emergency authorizations as assigned.
- Performs concurrent reviews for inpatient/outpatient care and other levels of care as allowed by scope of practice and experience.
- In conjunction with providers and facilities, develops discharge plans and oversee their implementation.
- Performs quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatment.
- Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.
- Interacts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.
- Participates in quality improvement activities, including data collection, tracking, and analysis.
- Maintains an active work load in accordance with National Care Manager performance standards.
- Works with community agencies as appropriate.
- Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.
- Participates in network development including identification and recruitment of quality providers as needed.
- Advocates for the patient to ensure treatment needs are met.
- Interacts with providers in a professional, respectful manner that facilitates the treatment process.
- The job duties listed above are representative and not intended to be all-inclusive... (we can keep but it's generic; maybe we can keep as part of responsibilities but it's not substantive? It's a note; we could keep but it's not adding new info; but we can keep as part of responsibilities.)
Then "Responsibilities Other Job Requirements" heading appears but we need to parse.
After that: "Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements. One or more of the following licensure is required for this role with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN. Minimum 2 years 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, plan and implement solutions that directly influence quality of care."
Then "General Job Information Title Care Manager, BH - Remote PA Grade 25 Work Experience - Required Clinical Work Experience - Preferred Education - Required Associate - Nursing, Bachelor's - Social Work, Master's - Social Work Education - Preferred License and Certifications - Required CEAP - Certified Employee Assistance Professional - Care MgmtCare MgmtCare Mgmt, LCSW - Licensed Clinical Social Worker - Care MgmtCare MgmtCare Mgmt, LMFT - Licensed Marital and Family Therapist - Care MgmtCare MgmtCare Mgmt, LMSW - Licensed Master Social Worker - Care MgmtCare MgmtCare Mgmt, LPC - Licensed Professional Counselor - Care MgmtCare MgmtCare Mgmt, LSW - Licensed Social Worker - Care MgmtCare MgmtCare Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare MgmtCare Mgmt License And Certifications - Preferred Salary Range Salary Minimum $64,285 Salary Maximum $102,855 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing."
Then EEO etc which we remove.
We need to structure into sections: About the role (maybe a brief summary), Responsibilities (list of duties), Requirements (licensure, experience), Qualifications (education, etc), Skills (organization, time management, communication, knowledge...), Benefits (benefits package mention), Pay (salary range), Schedule (maybe remote? Not explicit schedule; but we have remote; schedule not given; we should not create Schedule section unless posting actually states it. It does not mention schedule specifics, so we should not include Schedule.)
We need to decide which sections to include based on content.
We have:
- About the role: Could be a paragraph summarizing the role: remote, licensed in PA, under supervision, etc. We have that content.
- Responsibilities: list of duties (the bullet-like sentences). We'll put - for each duty.
- Requirements: licensure required, minimum 2 years experience post degree, etc. Also maybe "Licensure is required..." and "Minimum 2 years experience..."
- Qualifications: Education required (Associate - Nursing, Bachelor's - Social Work, Master's - Social Work) and preferred education? Also "Education - Preferred" maybe not given specifics; but we have Education - Required list. Also "License and Certifications - Required" list (CEAP, LCSW, LMFT, LMSW, LPC, LSW, RN). Also "License And Certifications - Preferred" (no specifics). We could combine licensure under Requirements or Qualifications. The instruction: Use headings for sections like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. So we need to decide what goes where.
Typically:
- About the role: brief overview.
- Responsibilities: duties.
- Requirements: mandatory qualifications (licensure, experience).
- Qualifications: education, preferred qualifications, etc.
- Skills: specific skills (organization, time management, communication, knowledge of utilization management, DSM V, ability to analyze, etc.)
- Benefits: benefits package mention.
- Pay: salary range.
- Schedule: not present, so omit.
We must not create sections with filler like "not specified". So we omit Schedule.
Now we need to ensure we preserve all substantive information. Let's extract.
From the text:
Remote, licensed in PA.
Under general supervision, collaborates with clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings.
Collects and analyzes utilization data.
Assists with discharge planning and care coordination.
Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects.
Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.
Provides telephone triage, crisis intervention and emergency authorizations as assigned.
Performs concurrent reviews for inpatient and/or outpatient care and other levels of care as allowed by scope of practice and experience.
In conjunction with providers and facilities, develops discharge plans and oversee their implementation.
Performs quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatment.
Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.
Interacts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.
Participates in quality improvement activities, including data collection, tracking, and analysis.
Maintains an active work load in accordance with National Care Manager performance standards.
Works with community agencies as appropriate.
Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.
Participates in network development including identification and recruitment of quality providers as needed.
Advocates for the patient to ensure treatment needs are met.
Interacts with providers in a professional, respectful manner that facilitates the treatment process.
The job duties listed above are representative and not intended to be all-inclusive... (we could keep as a note but it's generic; maybe we can include as a final li item? It's not a duty but a note; we could include as a paragraph after list.)
Now Requirements:
- Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements.
- One or more of the following licensure is required for this role with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN.
- Minimum 2 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care setting.
Also maybe "Strong organization, time management and communication skills." That's more 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, plan and implement solutions that directly influence quality of care.
These could be Skills.
Qualifications:
Education - Required Associate - Nursing, Bachelor's - Social Work, Master's - Social Work
Education - Preferred (not specified details) maybe omitted.
License and Certifications - Required list (CEAP, LCSW, LMFT, LMSW, LPC, LSW, RN). Note there is duplication with earlier list; we should include all.
License And Certifications - Preferred (no specifics) maybe omit.
Also "Work Experience - Required Clinical Work Experience - Preferred" maybe not needed.
We also have "Grade 25" maybe not needed.
Now Benefits:
- Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
- This position may be eligible for short-term incentives as well as a comprehensive benefits package.
We can combine.
Pay:
- Salary Minimum $64,285 Salary Maximum $102,855
- This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
- This position may be eligible for short-term incentives as well as a comprehensive benefits package (already in benefits). Might duplicate but okay.
Now we need to output HTML fragment with headings
and content.
We must not include any markdown fences.
We'll produce something like:
About the role
This remote position requires a current Pennsylvania license. Under general supervision, the Care Manager collaborates with the clinical team to authorize and review utilization of mental health and substance abuse services in inpatient and/or outpatient settings, collects and analyzes utilization data, assists with discharge planning and care coordination, provides member assistance, participates in quality improvement projects, monitors level of care for medical necessity, provides telephone triage and crisis intervention, conducts concurrent reviews, develops discharge plans, performs quality clinical reviews, educates members and providers about benefits and resources, interacts with Physician Advisors, participates in quality improvement activities, maintains workload per National Care Manager standards, works with community agencies, proposes alternative treatment plans when needed, participates in network development, advocates for patients, and interacts professionally with providers.
But we need to preserve all substantive info; we can break into list for responsibilities.
Better: Keep About the role as a short paragraph summarizing remote and PA license.
Then Responsibilities as - each duty.
We must ensure we don't miss any duty.
Let's list duties precisely as sentences:
1. Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings.
2. Collect
and content.
We must not include any markdown fences.
We'll produce something like:
About the role
This remote position requires a current Pennsylvania license. Under general supervision, the Care Manager collaborates with the clinical team to authorize and review utilization of mental health and substance abuse services in inpatient and/or outpatient settings, collects and analyzes utilization data, assists with discharge planning and care coordination, provides member assistance, participates in quality improvement projects, monitors level of care for medical necessity, provides telephone triage and crisis intervention, conducts concurrent reviews, develops discharge plans, performs quality clinical reviews, educates members and providers about benefits and resources, interacts with Physician Advisors, participates in quality improvement activities, maintains workload per National Care Manager standards, works with community agencies, proposes alternative treatment plans when needed, participates in network development, advocates for patients, and interacts professionally with providers.
But we need to preserve all substantive info; we can break into list for responsibilities. Better: Keep About the role as a short paragraph summarizing remote and PA license. Then Responsibilities as- each duty. We must ensure we don't miss any duty. Let's list duties precisely as sentences: 1. Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings. 2. Collect