Clinical Care Manager

Carolina Behavioral Health Alliance (CBHA), a third party administrator for behavioral health care benefits based in Winston-Salem, NC, is seeking a part time (20 hours per week) Clinical Care Manager to work in its Winston-Salem, NC office.  The ideal candidate will possess excellent written, telephone, computer and interpersonal communication skills.  Must be able to thrive in a multi-tasking environment.

Job Purpose:

The Clinical Care Manager helps members find appropriate behavioral healthcare providers, authorizes all levels of care based on established medical necessity criteria and provides on-going care management services to members who meet established criteria.

Duties:

• Conducts clinical intakes for enrollees.

• Conducts reviews on all levels of care and authorizes that care based on established medical necessity criteria.

• Provides on-going care management for eligible members who meet specified criteria for the service.

• Initiates outreach calls to members identified in the Disease Management program.

• Consults with the Medical Director on all complex cases.

• Provides feedback to the Professional Relations Department regarding provider recruitment needs.

• Participates in the Quality Improvement program of CBHA.

Requirements:

• Must possess a master’s degree in psychology, counseling, social work or a related field with licensure in the State of North Carolina or possess licensure as a Registered Nurse in the State of North Carolina.

• Must have worked in a behavioral health setting for at least two years.

• Must be able to work well in a multi-disciplinary, interdepartmental team environment.

• Must possess information system skills and be versed in Word, Excel and Access.

• Prefer candidates with experience in utilization review, managed care or inpatient psychiatric care.

Interested candidates may send their resumes to: careers@cbhallc.com

Or mail to:

Carolina Behavioral Health Alliance
ATTN: Jay Hale- Director of Quality Improvement & Clinical Operations
PO Box 571137
Winston-Salem, NC 27157