**Experienced Care Manager – Behavioral Health Treatment (BHT) Management and Coordination**

Remote, USA Full-time
Are you a compassionate and detail-oriented professional with a passion for delivering exceptional care to individuals in need? Do you thrive in a dynamic and fast-paced environment where no two days are ever the same? If so, we invite you to join the esteemed team at blithequark as a Care Manager, where you will play a vital role in shaping the lives of our members through expert Behavioral Health Treatment (BHT) management and coordination. **About blithequark** At blithequark, we are dedicated to revolutionizing the healthcare industry by providing innovative solutions that prioritize member service and care management. Our organization is built on a foundation of integrity, accountability, and a commitment to excellence. As a Care Manager, you will be part of a dynamic team that is passionate about making a meaningful impact on the lives of our members. **Job Overview** As a Care Manager at blithequark, you will be responsible for overseeing and evaluating BHT, including Applied Behavior Analysis (ABA) services, for eligible members. Your primary objective will be to ensure that our members receive the highest quality of care based on medical necessity. You will work closely with our team to fulfill departmental objectives and support both immediate and long-term goals. **Key Responsibilities** • Navigate a mission-focused environment dedicated to excellence in member service and care management, demonstrating integrity and accountability. • Collaborate effectively with team members to fulfill departmental objectives and support both immediate and long-term goals. • Assess requests for medical appropriateness and verify referrals according to established clinical guidelines. • Collect pertinent medical information for review by the Medical Director and communicate decisions clearly. • Accurately document all necessary information in the utilization management system, ensuring updates on authorizations are recorded. • Conduct thorough reviews of submitted documentation for compliance with coding (ICD-10, CPT-4, HCPCS) and coverage guidelines. • Maintain adherence to established policies and procedures while conducting quality reviews of documents. • Promptly notify providers and members of decisions made, ensuring timely and effective communication. • Stay updated on federal, state, and local regulations pertaining to the BHT benefit. • Identify potential quality concerns and report them as necessary, assisting with case audits when required. • Participate in additional projects and responsibilities as assigned. **Required Skills** • Establish and nurture strong relationships with colleagues and external partners from diverse backgrounds. • Work autonomously while exercising sound judgment in decision-making. • Communicate effectively in both verbal and written formats. • Adapt to a flexible work schedule that may include evenings and weekends. • Exhibit strong organizational, analytical, problem-solving, and project management skills. • Prosper in a fast-paced work environment while managing multiple tasks simultaneously. • Inspire and motivate team members and external committees. • Demonstrate proficiency in Microsoft Office Suite (Word, Outlook, Excel, PowerPoint) and related applications. **Qualifications** • A Master’s degree in psychology, social work, counseling, or a related field, along with a minimum of four years of experience in providing ABA or mental health services, including clinical review and treatment plan oversight. • Current, unrestricted California license (LCSW, LPCC, LMFT, RN with BH experience, BCBA, or BCBA-D). **Career Growth Opportunities** At blithequark, we value your professional development and offer numerous opportunities for skill enhancement and career advancement within the healthcare sector. Our organization is committed to fostering a culture of growth and learning, where you can expand your expertise and take on new challenges. **Company Culture and Values** We foster a collaborative environment that emphasizes high-quality performance and member service, nurturing a culture of dignity and respect. Our team is passionate about delivering exceptional care and making a meaningful impact on the lives of our members. **Networking and Professional Opportunities** As a Care Manager at blithequark, you will have the chance to collaborate with a dedicated team, enhancing your professional network and skillset in the healthcare community. You will be part of a dynamic and supportive team that is committed to excellence and innovation. **Compensation and Benefits** • Competitive salary commensurate with experience. • Comprehensive health, dental, and vision insurance. • Retirement savings plan with company matching contributions. • Generous vacation and paid time off policies. **Employment Type** This is a full-time remote position, offering the flexibility and autonomy to work from the comfort of your own home. As a remote employee, you will be part of a virtual team that is connected and collaborative, with regular check-ins and communication to ensure seamless collaboration and success. **How to Apply** If you are a motivated and compassionate professional with a passion for delivering exceptional care, we invite you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, to [insert contact information]. We look forward to hearing from you and exploring how you can make a meaningful impact at blithequark. Apply for this job
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