Magellan Health·Hollidaysburg, Pennsylvania
The Care Manager authorizes and reviews the utilization of mental health and substance abuse services in inpatient and outpatient settings. They are responsible for discharge planning, care coordination, and performing quality clinical reviews to ensure medical necessity.
This will be an in onsite full time position working Monday-Friday in the Blair County OMH office at 81 Holliday Hills Dr., Hollidaysburg, PA. This position is not available for remote work.
Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings. Collects and analyzes utilization data. Assists with discharge planning and care coordination. Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects.
Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness.
Provides telephone triage, crisis intervention and emergency authorizations as assigned.
Performs concurrent reviews for inpatient and/or outpatient care and other levels of care as allowed by scope of practice and experience.
In conjunction with providers and facilities, develops discharge plans and oversee their implementation.
Performs quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatment.
Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.
Interacts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.
Participates in quality improvement activities, including data collection, tracking, and analysis.
Maintains an active work load in accordance with National Care Manager performance standards.
Works with community agencies as appropriate. Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.
Participates in network development including identification and recruitment of quality providers as needed.
Advocates for the patient to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process.
The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description.
Care Manager - BH (Onsite, PA, Hollidaysburg)
Grade: 25
Work Experience - Required
Work Experience - Preferred
Education - Required
Associate - Nursing, Bachelor's - Social Work, Master's - Social Work
Education - Preferred
License and Certifications - Required
CEAP - Certified Employee Assistance Professional - Care MgmtCare MgmtCare Mgmt, LCSW - Licensed Clinical Social Worker - Care MgmtCare MgmtCare Mgmt, LMFT - Licensed Marital and Family Therapist - Care MgmtCare MgmtCare Mgmt, LMSW - Licensed Master Social Worker - Care MgmtCare MgmtCare Mgmt, LPC - Licensed Professional Counselor - Care MgmtCare MgmtCare Mgmt, LSW - Licensed Social Worker - Care MgmtCare MgmtCare Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare MgmtCare Mgmt
License and Certifications - Preferred
Salary Minimum: $64,285
Salary Maximum: $102,855
This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Market context
Behavioral health employers in Pennsylvania often seek candidates with direct patient care experience, and roles can be more competitive when applicants also bring phlebotomy certification or experience in crisis, detox, or acute psychiatric settings. This posting requires a high school diploma or GED plus at least one year of patient care experience, and the listed requirements and benefits are AI-summarized from the original job description to save you research time. If you’re considering applying, review whether your experience matches the setting and be ready to highlight any behavioral-health or phlebotomy background.
On-site Home Visitor, LCSW/LMFT any state, RN/BSN, Fort Meade, Maryland
On site Home Visitor, RN/BSN-LCSW/LMFT can be from any state, JBLM, Washington
MFLC Assignment Ready Counselor