Behavioral Health Care Manager - Richmond, Virginia (67848VMJ)
WellPoint - Richmond, VA

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Responsible for managing psychiatric and chemical dependency facility-based and outpatient professional treatment through telephonic or written review. Primary duties may include, but are not limited to: Uses appropriate screening criteria, knowledge and clinical judgment assesses patient needs and assures that medically necessary treatment is provided in a quality, cost-effective manner. Follows guidelines to refer cases to Medical Advisors as appropriate. Utilizes skills and knowledge in psychiatric and chemical dependency assessment, negotiation, coordination, implementation, case planning, monitoring, and evaluating to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures member access to medical necessary, quality behavioral healthcare in a cost effective setting according to contract.Responsible for managing psychiatric and chemical dependency facility-based and outpatient professional treatment through telephonic or written review. Primary duties may include, but are not limited to: Uses appropriate screening criteria, knowledge and clinical judgment assesses patient needs and assures that medically necessary treatment is provided in a quality, cost-effective manner. Follows guidelines to refer cases to Medical Advisors as appropriate. Utilizes skills and knowledge in psychiatric and chemical dependency assessment, negotiation, coordination, implementation, case planning, monitoring, and evaluating to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures member access to medical necessary, quality behavioral healthcare in a cost effective setting according to contract.
WellPoint - 16 months ago - save job - block
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WellPoint, Inc. (WellPoint) is a health benefits company serving 35 million medical members, as of December 31, 2008. The Company is an...