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Title :
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MH/SA Care Manager
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Location :
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Western Region
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Classification :
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To be determined by qualification and experience o
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Position # :
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TBA
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General Statement of the Job :
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The MH/SA Care Manager provides multiple utilization review tasks, including review of service plans and authorization of clinically appropriate services. The MH/SA Care Manager works with service providers to facilitate appropriate service planning and service provision. As needed, the MH/SA Care Manager also conducts post service reviews of services to determine the appropriateness of services provided. Additionally, the MH/SA Care Manager will provide other clinical reviews, case consultations and training in order to facilitate the provision of clinically appropriate services to consumers with mental health and substance use disorders. This position is responsible for providing an array of functions to assist consumers in receiving clinically appropriate assessments and services. This involves assisting the Access Unit and Access Clinician in linking consumers to needed services within clinically appropriate time frames, including telephonic triage and determination of need for emergency services. In addition to providing clinical support to the Access Unit and Access Clinician, the MH/SA Care Manager will also directly handle telephonic requests for services at times of heavy call volume.
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Essential Job Functions :
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Review Person Centered Plans and Other Service Plans
• Review plans submitted by providers with authorization requests
• Where plans do not meet established standards for medical necessity, provide feedback and request additional information from providers, including consultation and education as appropriate.
• Render authorization determinations
o Authorize requested services meeting authorization requirements
o Complete and send Educational Notifications for requests not meeting sufficient information and other administrative requirements.
o Refer service requests for medical necessity determinations to a Clinical Peer when medical necessity is not established.
o Ensure complete documentation of review and determinations.
Facilitate Consumer Access to Care
• Provide clinical support to the Access Unit performing screening, triage and referral functions
• Directly handle service request calls at times of heavy call volume
• Handle crisis calls in the Access Unit: Triage calls for urgency and facilitate access to crisis services
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Minimum Training and Qualifications :
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A Masters degree in a Human Services field (such as Psychology, Social Work, etc) is required, along with at least two years of post-degree progressive experience providing services to the population served.
Experience in the public mental health field is highly desired due to the complexity of the work of the organization. Experience in a UM environment in Behavioral Healthcare would be valuable for this employee.
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Graduation from a State accredited school of nursing and two years of experience in psychiatric nursing which provides the knowledge, skills, and abilities needed to perform the work; or an equivalent combination of education and experience.
A degree alone does not prepare an applicant for this position. Experience providing mental health or substance abuse services are essential.
No experience can be substituted for the formal degree.
Valid licensure or certification in profession (social work, counseling or psychology) is required.
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Physical Requirements :
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Normal range of motion and reasonable physical health and strength will be required Visual attention sufficient to read, is necessary.. Mental concentration is required in review of assessments, etc. Typewriters, computers, copiers and other office equipment will be used routinely.
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Knowledge of Job :
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• A high level of diplomacy and discretion is required to effectively negotiate and resolve issues with minimal assistance. This will require exceptional interpersonal skills, highly effective communication ability, and the propensity to make prompt independent decisions based upon relevant facts. Problem solving, negotiation, arbitration and conflict resolution skills are essential to balance the needs of both internal and external customers.
• Ability to collaborate with providers and other agencies.
• Clinical knowledge of mental health and substance abuse treatment as a basis for clinical reviews and decisions for authorization.
• Comprehensive knowledge of resources and the ability to use a personal workstation. Knowledge of databases and data entry is essential.
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Salary :
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Grade/Step is determined by qualification and experience of candidate. Salary Range is $43,538 - $52,510. Positions are full-time salaried with comprehensive benefits. Work schedule is 37.5 hours per week. This position is exempt from overtime compensation.
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Deadline for Application :
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Positions are open until filled.
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Apply To :
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Send a NC State Application and resume to: Smoky Mountain Center, Department of Human Resources, 44 Bonnie Lane, Sylva, NC 28779. Smoky Mountain Center is an equal opportunity, affirmative action employer
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PLEASE NOTE THAT INTERNAL APPLICANTS SHOULD BE AWARE THAT CHANGING POSITIONS
WITHIN THE AGENCY COULD RESULT IN BEING RECLASSIFIED INTO TRAINEE STATUS WHICH
WOULD AFFECT YOUR RIGHTS AS A PERMANENT EMPLOYEE. WHEN APPLYING INTERNALLY, CHECK
CLOSELY WITH HIRING SUPERVISOR AND HUMAN RESOURCES COORDINATOR TO DETERMINE IF YOU
ARE FULLY QUALIFIED FOR POSITION OR IF YOU MUST SERVE IN TRAINEE STATUS UNTIL FULLY
QUALIFIED.
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