Sr. Clinical Care Navigator - License Required - Remote US

About the role

The navigator is a phone queue based role responsible for answering calls from Magellan members, individual providers, facilities, and customer representatives. Additional responsibilities may include training and mentoring newly hired navigators.

Responsibilities

• Answer calls from Magellan members, individual providers, facilities, and customer representatives.
• Provide utilization management review and authorization of behavioral health and substance use disorder services ranging from outpatient counseling to inpatient levels of care.
• Assist members and facilities in coordinating and accessing benefit eligible treatment.
• Manage crisis calls, assess members for all types of risk following Magellan's established crisis call protocols, and provide WPS Supervisor Consultations.
• Provide in-person outreach to members assessed as high risk.
• Assist members with accessing benefit eligible EAP, BH, or SUD treatment via bed searches and routine/urgent apointment searches.
• Manage requests and complete outreach for Critical Incident Response event staffing.
• Complete required corporate and clinical trainings, participate in individual supervision and team meetings, gather and submit customer feedback, support Magellan holiday phone queue coverage, and assist with training/mentoring of new hires and existing staff.

Requirements

• Full clinical licensure with master's degree in social work, counseling, or similar area; License must be active in state employee works/lives.
• Minimum of 5 years' experience post-licensure in healthcare, behavioral health, social work, psychiatric and/or substance use disorder setting.
• Strong organization, time management, and communication skills.
• All new hires will need to be master's level licensed clinicians.
• CEAP certification as required by management.
• Knowledge of utilization management procedures, mental health, and substance abuse community resources and providers.
• Knowledge of and experience in inpatient setting.
• Knowledge of DSW V or most current diagnostic edition.
• Ability to analyze specific utiliation problems and plan and implement solutions that directly influence quality of care.
• Strong computer skills to utilize and navigate various systems.

Qualifications

• Full clinical licensure with master's degree in social work, counseling, or similar area; License must be active in state employee works/lives.
• Minimum of 5 years' experience post-licensure in healthcare, behavioral health, social work, psychiatric and/or substance use disorder setting.

Skills

• Strong organization, time management, and communication skills.
• Knowledge of utilization management procedures, mental health, and substance abuse community resources and providers.
• Knowledge of and experience in inpatient setting.
• Knowledge of DSW V or most current diagnostic edition.
• Ability to analyze specific utiliation problems and plan and implement solutions that directly influence quality of care.
• Strong computer skills to utilize and navigate various systems.

Benefits

• Employee Assistance Program (EAP) services including counseling, coaching, Critical Incident Response and Workplace Support Services (WPS).
• Outreach to members assessed as high risk.
• Access to benefit eligible EAP, BH, or SUD treatment via bed searches and routine/urgent apointment searches.
• Management of requests and complete outreach for Critical Incident Response event staffing.

Pay

$70,715 - $113,145

Schedule

Varies