Clinical Care Manager II (Union) - Michigan Licensed

About the role

The Clinical Care Manager II role involves conducting telephone assessments, referrals, and counseling. This position requires a Master’s degree in social work, psychology, counseling, or a Bachelor’s level RN, along with a current, valid, and unrestricted license in the State of Michigan in a mental health field.

Responsibilities

• Coordinate with other Care Managers to ensure comprehensive treatment needs are met.
• Ensure continuity of patient care through contact with providers.
• Maintain telephone superior service standards.
• Contribute to weekly staff meetings and clinical conferences.
• Attend appropriate meetings, trainings, and conference calls as scheduled.
• Perform all other aspects of customer service as required.
• Troubleshoot claims issues.
• Investigate and research to resolve customer complaint problems and issues.
• Apply Carelon Behavioral Health Options policies and procedures consistently.
• Maintain confidentiality of Clients, Business Records and Reports.
• Maintain ethical and professional standards.
• Maintain individual productivity and performance standards.
• Meet Departmental expectations, accuracy, productivity, and performance standards.
• Support Carelon Behavioral Health Options in achieving its Mission Statement.
• Complete tasks accurately and within required timeframes.
• Adhere to the components of the Compliance Program.
• Avoid non-compliance issues and notify supervisor or call Ethics Hotline.
• Adhere to compliance training requirements and understand that training is required condition of employment.

Requirements

Minimum requirements include a Master’s degree in social work, psychology, counseling, or a Bachelor’s level RN, a current, valid, and unrestricted license in the State of Michigan in a mental health field, and a minimum of 3 years’ experience in psychiatric or substance abuse treatment. Experience as a CEAP or EAP internal/external consultant to a work site area is required (for the integrated unit only), or a minimum of 2 years’ experience prior to licensure with Carelon Behavioral Health Options Clinical Operations Unit functioning as a Clinical Support Specialist with required licensure activities supervised by the Clinical Manager or Clinical Director.

Qualifications

Preferred qualifications include experience in settings that include inpatient, partial, and/or outpatient care.

Skills

Knowledge of Carelon Behavioral Health Options clinical and work site guidelines, ability to make appropriate referral and certification decisions, and proficiency in utilizing professional knowledge to apply Carelon Behavioral Health Options criteria and render certification decisions are essential.

Benefits

Benefits include a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, among others.

Pay

Pay varies based on shift differential: 2nd shift (M-F between the hours of 4:30 pm to 1:00 am) - 5%, 3rd shift (M-F between the hours of 1:00 am to 9:30 am) - 10%, Weekend (Shifts in between the hours of 9:30 am Saturday and 1:00 am Monday) - 10%.

Schedule

Shift: Sunday through Thursday, from 2:00am - 10:30am. Training will be provided for 5 weeks during regular business hours.

Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Location

Location: Dearborn, MI

Evaluation

Will facilitate all tracking for necessary quality indicators to meet these necessary accrediting bodies (NCQA, URAC).

Special Projects

Will facilitate all tracking for necessary quality indicators to meet these necessary accrediting bodies (NCQA, URAC).

Other Duties

Will facilitate all tracking for necessary quality indicators to meet these necessary accrediting bodies (NCQA, URAC).