Beacon Health Options
Job Category: Clinical – General
Req #: CLINI02960
Schedule: Full Time
Location: CA – Cypress
About the Position:
Beacon Health Options is seeking a Clinical Care Manager Team Lead to join our Outpatient team in Cypress, CA. The Outpatient Clinical Team Lead is responsible for screening, triaging, and assessing member to determine appropriate level of care based on medical necessity criteria. The Team Lead is also responsible for outpatient utilization management and monitoring activities of mental health services provided in outpatient care settings, including supervision of outpatient clinical case managers.
*This position may require work until 6pm for 2 – 3 days of the week*
- Provide telephonic screening, urgent/emergent triage based on appropriate level of care.
- Utilization review of providers based on claims triggers data and six month review.
- Interact with Beacon Physician Advisors to facilitate PCP Decision Support consultation.
- Interact with outpatient providers and members in a professional and respectful manner.
- Provide information to members and providers regarding mental health and community treatment resources.
- Collaborate with providers, county representatives, health plans, regarding appropriate level of care.
- Assist outpatient case manager in application of level of care criteria as it applies to screening and utilization management.
- Identifies and refers high risk members to care management based on level of care critiera.
- Recognize quality of care issues and report them appropriately through internal and external processes.
- Assist in collection of outcomes information, annual analysis and other reporting and initiatives.
- Comply with all Beacon policy guidelines, external regulatory requirements and URAC/NCQA accreditation standards.
- Attend clinical meetings
- Assist with NCQA, URAC and other QI initiatives.
- Supervision of clinical outpatient case managers.
- All other duties as assigned
- Education: Masters Degree in a healthcare or mental health field required
- Licensure: Current, valid, unrestricted independent license in behavioral health or nursing (MSW, LMFT, LPCC, PhD, PsyD, etc.) in CA required and must practice within the scope of their licensure
- Relevant Work Experience: 5 years of combined direct behavioral health clinical and managed care experience required with supervisory experience preferred
If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!
Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled
At Beacon Health Options, our candidate’s data privacy is a top priority. Our recruiting team conducts all communications using official company email Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.
Care Manager Team Lead – Cypress, California