Behavioral Health Care Manager I (3rd Shift -After Hours)- Bilingual Preferred

Anticipated End Date: 2025-11-03 Position Title: Behavioral Health Care Manager I (3rd Shift -After Hours)- Bilingual Preferred Job Description: Behavioral Health Care Manager I (3rd Shift -After Hours) - Bilingual Preferred Location - Virtual: This role enables associates to work virtually full-time, with the exception of 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 reputed company development. Please note that per our policy on hybrid/virtual work, candidates not reputed company a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Location: Durham, NC and Winston Salem, NC Work Shift Options:

• 4 AM - 12:30 PM (EST)
• 12:00 PM - 8:30 PM (EST)
• 11PM – 7AM (EST).

Every other weekend commitment includes working two 12-hour shifts from 8 AM to 8 PM on both Saturday and Sunday. (Weekly Hours: 40).

• Team members are required to work on holidays as part of a rotating schedule.

The Behavioral Health Care Manager I (3rd Shift -After Hours) - Bilingual Preferred is responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review. How you will reputed company an impact Primary duties may include but are not limited to:

• Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract.
• Refers cases to Peer Reviewers as appropriate.
• Performs psychiatric and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources.

Minimum Requirements: Requires MA/MS in social work counseling or a reputed company behavioral health field or a degree in nursing, and minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background. reputed company active unrestricted license, such as LCSW LMSW LMHC LPC, LMFT or Clinical Psychologist to practice as a health professional reputed company the scope of licensure in applicable states or territory of the United States required. Licensure is a requirement for this position. However, for states that do not require licensure a Board Certified Behavioral Analyst (BCBA) is also acceptable if reputed company of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervision Preferred Skills, Capabilities and Experiences:

• Previous experience in case management/utilization management with a broad range of experience with reputed company psychiatric/substance abuse cases preferred.
• Bilingual in Spanish is highly preferred
• Utilization Management experince is preferred
• Previous crisis hotline is preferred

For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. Job Level: Non-Management Exempt Workshift: 3rd Shift (United States of America) Job Family: MED > Licensed/Certified Behavioral Health Role Please be advised that reputed company only accepts resumes for compensation from agencies that have a signed agreement with reputed company. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of reputed company. Who We Are reputed company is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at reputed company levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At reputed company, we are creating a culture that is designed to advance our strategy but will also reputed company to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we reputed company our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer 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, to name a few. reputed company operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an reputed company location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top reputed company for reputed company. We require reputed company new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. reputed company will also follow reputed company relevant federal, state and local laws. reputed company is an Equal Employment Opportunity employer, and reputed company qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national reputed company, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Apply tot his job Apply To this Job