Counselor

//Looking for only those who resides in California State//Job details are Shared below: Job Title: Care ManagerLocation: 100% Remote (only California)Job Duration: 3+m Contract with potential for conversionPrimary Skills: Experience in Care managementTriage experience for mental health and substance healthExperience with utilization management, utilization review, applying medical necessity criteria, high level of care utilization review, conducting or completing prior authorizations and completing concurrent reviews (CCR).Certifications Required (anyone) - LCSW - Licensed Clinical Social Worker, LMFT - Licensed Marriage and Family Therapist, LMSW - Licensed Master Social Worker, LPC - Licensed Professional Counselor, RN - Registered Nurse, State and/or Compact State LicensureLicensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirementsOne or more of the following licensure is required for this role with necessary degrees: CEAP, LMSW, LCSW, LPC, RNMinimum 2 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care settingStrong organization, time management and communication skillsKnowledge of utilization management procedures, mental health and substance abuse community resources and providersKnowledge and experience in inpatient and/or outpatient settingKnowledge of DSM V or most current diagnostic editionAbility to analyze specific utilization problems, plan and implement solutions that directly influence quality of careNice To have:DSM and ASM knowledgeResponsibilities:Performs concurrent reviews for inpatient and/or outpatient care and other levels of care as allowed by scope of practice and experienceIn conjunction with providers and facilities, develops discharge plans and oversee their implementationPerforms quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatmentProvides 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 criteriaInteracts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific casesParticipates in quality improvement activities, including data collection, tracking, and analysisMaintains an active work load in accordance with National Care Manager performance standardsWorks with community agencies as appropriateProposes alternative plans of treatment when requests for services do not meet medical necessity criteriaParticipates in network development including identification and recruitment of quality providers as neededAdvocates for the patient to ensure treatment needs are metInteracts with providers in a professional, respectful manner that facilitates the treatment processSummary: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..Qualification:Bachelor's degree or relevant experience. Please respond at the earliest to speed up the interview process. I will contact you if I need further details.Amit BundeleTechnical RecruiterPhone : 669-319-4167Email amitb@San Jose, California

Created: 2025-09-23