Community Behavioral Health.
Hybrid (Philadelphia, PA, USA)
The Clinical Care Manager is responsible for utilization management by conducting utilization review activities, population management, cross-system consultation, provider management and treatment quality monitoring. The Clinical Care Manager must utilize clinical knowledge of best practices and evidence based treatments to ensure CBH members receive timely access to quality, medically necessary behavioral health services. When clinically indicated, Clinical Care Managers consult with CBH Physician and Psychologist Advisors to ensure the most effective treatment for the CBH member is being authorized. Available SHIFTS ( require staff to attend provider meetings on site ) Evening: Monday - Friday 4pm -12am Weekend: Sat - Mon: 8am - 9pm Essential Functions : Be knowledgeable about behavioral health care services, system partners, service continuum and established medical necessity criteria and apply that knowledge in all work activities....