ABOUT OUR COMPANY
ValueOptions ® is a health improvement company that serves more than 32 million individuals. On behalf of employers, health plans and government agencies, we manage innovative programs and solutions that directly address the challenges our health care system faces today. A national leader in the fields of mental and emotional wellbeing, recovery and resilience, employee assistance, and wellness, ValueOptions helps people make the difficult life changes needed to be healthier and more productive. With offices nationwide and a network of more than 130,000 provider locations, ValueOptions helps people take important steps in the right direction. We help them live their lives to the fullest potential.
ABOUT OUR PEOPLE
At ValueOptions, it’s more than a job. Our employees embrace our vision of helping people lead healthier lives. Our 3,100 employees enjoy challenging career growth in an environment that values integrity, innovation, consumer engagement and joint accountability. At ValueOptions we strive to build a boundless culture and community of professionals that includes honest, open and free-flowing communication. Our employees are passionate about the work we do.
If you have a passion to make a difference and a thirst to actively develop your knowledge and skills, join the ValueOptions team!
ABOUT THE POSITION
We are currently seeking a dynamic Clinical Care Manager to join our team at our office in Colorado Springs, CO. The Clinical Care Manager will be r esponsible for ensuring authorization of medically necessary, covered, quality services at the least restrictive level of care within a coordinated care delivery system for CO Medicaid clients .
- Ensures integration of care and effective utilization of resources through review of documentation, discussion with providers and members, application of clinical guidelines and appropriate authorization of services.
- Responsible for initial authorization of medically necessary services for contracts delegated from other VO service centers.
- Documentation and Coding Entries - Demonstrates thorough, relevant clinical documentation and accurate coding of all utilized computer screens.
- Contractual Adherence - Adheres to contract specific work flows and procedures by documenting and authorizing all requirements as indicated by the contract guidelines under which the client's insurance falls.
- Emergency Call Management - Triages callers in crisis for immediate clinical assessment.
Education : Minimum of a master’s degree in mental health related discipline or a minimum of an associate’s degree in nursing with related psychiatric nursing experience. Individuals who conduct initial clinical review possess an active, professional license or certification: To practice as a health professional in a state or territory of the United States; and with a scope of practice that is relevant to the clinical area(s) addressed in the initial review. Current, valid and unrestricted license in a state or territory of the United States in a mental health field (RN, Ph.D., LCSW/ACSW, LLP, MHC, LPC, etc.)
Relevant Work Experience: 3-5 years direct practice experience in psychiatric or substance abuse treatment. Experience in settings that include inpatient, partial and or outpatient care preferred. For some rolesexperience as a CEAP or EAP internal/external consultant to a work site may be required..
Knowledge, Skills & Abilities :
- Excellent telephonic customer service skills and computer skills are required.
- Successful candidate must have proven track record of customer service, strong work ethic and be prepared to support teammates in the missoin of excellent service to providers and members .
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ValueOptions is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.
ValueOptions, a Beacon Health Options company, is a health improvement organization that serves more than 34.2 million individuals. On...