Care Manager - Remote Opportunity at blithequark: Transforming Lives through Exceptional Behavioral Health Care

Join blithequark, a Leader in Healthcare Innovation At blithequark, we're dedicated to revolutionizing the healthcare landscape by providing top-notch services that make a meaningful difference in the lives of our members. As a pioneering organization in the healthcare sector, we're committed to fostering a culture of excellence, integrity, and compassion. Our mission is to deliver high-quality care that addresses the unique needs of our members, and we're seeking a skilled and empathetic Care Manager to join our dynamic team. About the Role: Care Manager - Remote As a Care Manager at blithequark, you will play a pivotal 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. This is a 100% remote opportunity, allowing you to work from the comfort of your own space while making a significant impact on the lives of those we serve. 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. Essential Qualifications To excel as a Care Manager at blithequark, you should possess: A Master’s degree in psychology, social work, counseling, or a related field. 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). Strong relationships with colleagues and external partners from diverse backgrounds. Ability to work autonomously while exercising sound judgment in decision-making. Effective communication skills in both verbal and written formats. Adaptability to a flexible work schedule that may include evenings and weekends. Strong organizational, analytical, problem-solving, and project management skills. Proficiency in Microsoft Office Suite (Word, Outlook, Excel, PowerPoint) and related applications. Preferred Skills and Competencies In addition to the essential qualifications, we highly value: Experience working in a fast-paced environment with multiple tasks and priorities. Ability to inspire and motivate team members and external committees. Knowledge of current industry trends and best practices in behavioral health care. Strong analytical and critical thinking skills. Career Growth Opportunities and Learning Benefits At blithequark, we're committed to your professional development and offer numerous opportunities for skill enhancement and career advancement within the healthcare sector. As a Care Manager, you'll have the chance to: Develop your clinical and management skills through ongoing training and education. Collaborate with a dedicated team of professionals, enhancing your network and expertise. Participate in quality improvement initiatives and contribute to the development of best practices. Advance your career within our organization, taking on new challenges and responsibilities. Work Environment and Company Culture At blithequark, we foster a collaborative environment that emphasizes high-quality performance and member service, nurturing a culture of dignity and respect. As a remote team member, you'll be part of a dynamic and supportive community that values: Integrity and accountability. Compassion and empathy. Innovation and continuous improvement. Diversity and inclusivity. Compensation, Perks, and Benefits We offer a comprehensive compensation package that includes: 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. Opportunities for professional development and career advancement. Join Our Team: Make a Meaningful Difference in Healthcare If you're a dedicated and compassionate professional looking to make a significant impact in the lives of others, we invite you to join our team at blithequark. As a Care Manager, you'll play a vital role in delivering exceptional behavioral health care and advancing our mission to provide high-quality services that transform lives. Apply now to become part of our dynamic team and take the first step towards a rewarding and challenging career in healthcare. Employment Type: Full-Time Location: Remote (100% work-from-home opportunity) Apply for this job