Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract
Refers cases to Peer Reviewers as appropriate
Performs psychiatric and substance abuse or substance abuse disorder assessment coordination, implementation, case planning, monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources

Requires MA/MS in social work, counseling or a related behavioral health field or a degree in nursing
Minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment
Current active unrestricted Colorado license (e.g., RN, LCSW, LMHC, LPC, LMFT or Clinical Psychologist) to practice as a health professional within the scope of licensure in Colorado is required
Experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases (preferred)
Experience with substance abuse treatment and ASAM levels of care knowledge as well as in-home intensive therapy modalities (strongly preferred)
Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills (strongly preferred)

Behavioral Health Care Manager – Utilization Management

Key skills