Experienced Care Manager – Behavioral Health Treatment (BHT) – Remote Opportunity at arenaflex
About arenaflex
At arenaflex, we are a dynamic and esteemed healthcare organization dedicated to delivering exceptional care and service to our members. Our mission is to provide a supportive and collaborative environment where our team members can thrive and make a meaningful impact on the lives of those we serve. With a strong focus on excellence, integrity, and accountability, we strive to be a leader in the healthcare industry.Job Overview
We are seeking an experienced Care Manager to join our team in a 100% remote role. As a Care Manager, you will play a vital role in overseeing and evaluating Behavioral Health Treatment (BHT), including Applied Behavior Analysis (ABA) services, for eligible members. Your primary responsibility will be to ensure that our members receive the highest quality of care based on medical necessity. If you are a motivated and compassionate professional with a passion for delivering exceptional care, we encourage you to apply for this exciting opportunity.Key Responsibilities
As a Care Manager at arenaflex, you will be responsible for:- Navigating a mission-focused environment dedicated to excellence in member service and care management, demonstrating integrity and accountability.
- Collaborating effectively with team members to fulfill departmental objectives and support both immediate and long-term goals.
- Assessing requests for medical appropriateness and verifying referrals according to established clinical guidelines.
- Collecting pertinent medical information for review by the Medical Director and communicating decisions clearly.
- Accurately documenting all necessary information in the utilization management system, ensuring updates on authorizations are recorded.
- Conducting thorough reviews of submitted documentation for compliance with coding (ICD-10, CPT-4, HCPCS) and coverage guidelines.
- Maintaining adherence to established policies and procedures while conducting quality reviews of documents.
- Promptly notifying providers and members of decisions made, ensuring timely and effective communication.
- Staying updated on federal, state, and local regulations pertaining to the BHT benefit.
- Identifying potential quality concerns and reporting them as necessary, assisting with case audits when required.
- Participating in additional projects and responsibilities as assigned.
Required Skills
To succeed in this role, you will need to possess the following skills:- Establish and nurture strong relationships with colleagues and external partners from diverse backgrounds.
- Work autonomously while exercising sound judgment in decision-making.
- Communicate effectively in both verbal and written formats.
- Adapt to a flexible work schedule that may include evenings and weekends.
- Exhibit strong organizational, analytical, problem-solving, and project management skills.
- Prosper in a fast-paced work environment while managing multiple tasks simultaneously.
- Inspire and motivate team members and external committees.
- Demonstrate proficiency in Microsoft Office Suite (Word, Outlook, Excel, PowerPoint) and related applications.
Qualifications
To be considered for this role, you will need to possess the following qualifications:- A Master's degree in psychology, social work, counseling, or a related field, along with a minimum of four years of experience in providing ABA or mental health services, including clinical review and treatment plan oversight.
- Current, unrestricted California license (LCSW, LPCC, LMFT, RN with BH experience, BCBA, or BCBA-D).
Career Growth Opportunities
At arenaflex, we value your professional development and offer numerous opportunities for skill enhancement and career advancement within the healthcare sector. Our organization is committed to helping you grow and succeed in your career, and we encourage you to explore our various training programs and professional development opportunities.Company Culture And Values
We foster a collaborative environment that emphasizes high-quality performance and member service, nurturing a culture of dignity and respect. Our team members are passionate about delivering exceptional care and service, and we strive to create a workplace that is inclusive, supportive, and empowering.Networking And Professional Opportunities
In this role, you will have the chance to collaborate with a dedicated team, enhancing your professional network and skillset in the healthcare community. Our organization is committed to building strong relationships with external partners and stakeholders, and we encourage you to participate in industry events and conferences to stay up-to-date on the latest developments in the field.Compensation And Benefits
We offer a competitive salary commensurate with experience, as well as a comprehensive benefits package that includes:- Comprehensive health, dental, and vision insurance.
- Retirement savings plan with company matching contributions.
- Generous vacation and paid time off policies.