Integrated Case Manager

The Integrated Case Manager position for Uprise Health is a full-time position focused on telephonic utilization management and clinical assessment for behavioral health and EAP services.

Essential Duties and Responsibilities:

• Provide utilization management services for mental health and substance abuse higher levels of care, including precertification and concurrent review.
• Assess clinical information provided and apply medical necessity criteria.
• Coordinate behavioral health physician advisor activities.
• Coordinate discharge planning needs with facility, health services providers, members and family.
• Provide care coordination with and facilitate referrals to physical health providers, social services and disability services as needed.
• Record and resolve member and provider inquiries and complaints in accordance with company policies and procedures.
• Triage calls from members in crisis and assist to ensure safety and access to appropriate care.
• Provide concurrent and retrospective reviews of ABA and Psychological Testing requests as submitted.
• Maintain accurate and complete documentation in system.
• Provide clinical support and consultation to other clinical staff, conduct staff meetings and provide link to the BH Medical Director.
• Act as the Clinical Team lead and maintain good working relationship and communication with the AVP BH Clinical Ops.
• Other responsibilities as appropriate

• License in a state or territory of the United States to practice as a independent mental health professional (e.g., LMFT, LPC, LCSW, LICSW, PhD) required.
• Master’s degree or higher in a mental health field required.
• Experience:
  1. Minimum of 5 years clinical experience required.
  2. Experience triaging behavioral health crises required.
  3. Experience leading a team and clinical supervision with good communication skills
  4. Experience with various software programs including Microsoft Word, Excel, Outlook, Inter Qual – minimum of intermediate level required.
  5. Experience in utilization management or utilization review required.
  6. Bilingual preferred.
  7. Experience working with Taft-Hartley Trust Funds preferred.

Working Environment: 

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee regularly works near office equipment (telephone, computer) and other employees. The employee works in normal office conditions where there is no physical discomfort due to temperature, dust, noise, etc. Verbal and written communication, telephone usage, filing, sitting, typing, driving, reading and carrying required to perform the essential functions of this job.