Job Description
The Case Manager role is suited for individuals who are nurses, licensed marriage family therapists, or certified professional counselors. The Case Manager will perform utilization management by applying MCG criteria or medical policy to make behavioral health medical necessity service request decisions. This role involves processing service requests for behavioral health inpatient hospital admissions, residential treatment center admissions, partial hospitalization program requests, intensive outpatient program requests, and prior authorization services such as TMS, ECT, and neuropsychiatric testing.
ResponsibilitiesPerform utilization management by applying MCG criteria or medical policy.Make behavioral health medical necessity service request decisions.Process behavioral health inpatient hospital admission requests.Handle residential treatment center admission requests.Manage partial hospitalization program requests.Process intensive outpatient program requests.Handle prior authorization services including TMS, ECT, and neuropsychiatric testing.Essential SkillsUtilization managementUtilization reviewMCGPrior authorizationAcute careInpatient careProficiency in Microsoft Office1 year of Utilization Review/Management experience requiredBehavioral health knowledgeAdditional Skills & QualificationsCA LVNAssociate's Degree requiredStrong verbal communication skillsStrong written communication skillsAbility to work with Medical DirectorsAbility to stay organizedAbility to prioritize tasks effectivelyWork Environment
The work environment includes utilizing various technologies and equipment to process requests. The role may require interaction with medical directors and other healthcare professionals. The position necessitates strong organizational skills and the ability to prioritize tasks effectively.
Pay and BenefitsThe pay range for this position is $35.00 - $45.00
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position will be accepting applications until Jan 26, 2025.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & InclusionAt Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
Hiring diverse talent Maintaining an inclusive environment through persistent self-reflection Building a culture of care, engagement, and recognition with clear outcomes Ensuring growth opportunities for our peopleThe company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.