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

At arenaflex, we are dedicated to delivering exceptional care and service to our members, and we are seeking a highly skilled and compassionate Care Manager to join our dynamic team. As a Care Manager, you will play a vital role in overseeing and evaluating Behavioral Health Treatment (BHT), including Applied Behavior Analysis (ABA) services, for eligible members. Your expertise and dedication will ensure that our members receive the highest quality of care based on medical necessity.

Job Overview

arenaflex is a leading healthcare organization that is committed to excellence in member service and care management. Our mission is to provide personalized and compassionate care to our members, and we are seeking a talented Care Manager to join our team. As a Care Manager, you will have the opportunity to make a significant impact on the lives of our members and contribute to the success of our organization.

Key Responsibilities

As a Care Manager, you will be responsible for the following key responsibilities:

• Navigating a mission-focused environment dedicated to excellence in member service and care management, demonstrating integrity and accountability.
• Collaborating effectively with team members to fulfill departmental objectives and support both immediate and long-term goals.
• Assessing requests for medical appropriateness and verifying referrals according to established clinical guidelines.
• Collecting pertinent medical information for review by the Medical Director and communicating decisions clearly.
• Accurately documenting all necessary information in the utilization management system, ensuring updates on authorizations are recorded.
• Conducting thorough reviews of submitted documentation for compliance with coding (ICD-10, CPT-4, HCPCS) and coverage guidelines.
• Maintaining adherence to established policies and procedures while conducting quality reviews of documents.
• Promptly notifying providers and members of decisions made, ensuring timely and effective communication.
• Staying updated on federal, state, and local regulations pertaining to the BHT benefit.
• Identifying potential quality concerns and reporting them as necessary, assisting with case audits when required.
• Participating in additional projects and responsibilities as assigned.

Required Skills

To be successful in this role, you will need to possess the following skills:

• Establishing and nurturing strong relationships with colleagues and external partners from diverse backgrounds.
• Working autonomously while exercising sound judgment in decision-making.
• Communicating effectively in both verbal and written formats.
• Adapting to a flexible work schedule that may include evenings and weekends.
• Exhibiting strong organizational, analytical, problem-solving, and project management skills.
• Thriving in a fast-paced work environment while managing multiple tasks simultaneously.
• Inspiring and motivating team members and external committees.
• Demonstrating proficiency in Microsoft Office Suite (Word, Outlook, Excel, PowerPoint) and related applications.

Qualifications

To be considered for this role, you will need to possess the following 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

arenaflex values your professional development and offers numerous opportunities for skill enhancement and career advancement within the healthcare sector. Our organization is committed to helping you grow and succeed in your career, and we offer a range of training and development programs to support your growth.

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 organization is committed to providing a supportive and inclusive work environment that values diversity, equity, and inclusion.

Networking and Professional Opportunities

In this role, you will have the chance to collaborate with a dedicated team, enhancing your professional network and skillset in the healthcare community. You will also have the opportunity to participate in professional development opportunities, including conferences, workshops, and training programs.

Compensation and Benefits

arenaflex offers a competitive salary commensurate with experience, as well as a range of benefits, including:

• 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, and you will be required to work from home. You will need to have a reliable internet connection and a dedicated workspace to perform your duties.

How to Apply

If you are a motivated and compassionate individual who is passionate about delivering exceptional care and service, we encourage you to apply for this exciting opportunity. Please submit your resume and a cover letter outlining your qualifications and experience to [insert contact information]. We look forward to hearing from you! Apply for this job