[bsw] [swkcommunity] Job Opportunities

[Misty Lair]

Health Net, Inc. (NYSE: HNT) is among the nation's largest publicly traded
managed health care companies. Health Net's mission is to help people be
healthy, secure and comfortable. The company's POS, HMO, insured PPO,
behavioral health and government contracts subsidiaries provide health
benefits to more than 7 million individuals. For more information on Health
Net, Inc., please visit the company's Web site at www.healthnet.com
<http://www.healthnet.com> 

 

Due to our rapid growth in the Irving area, Health Net has immediate
opportunities for licensed LCSWs

 

To apply, please send your resume to:

Karen.E.Blum at healthnet.com

 

JOB SUMMARY:


Under the direction of the Supervisor, Care Management, the Care Manager is
responsible for the implementing the Care Management programs in multiple
environments including Prior Authorization, Concurrent Review and Care
Management. A patient advocacy approach with a seamless integration of
services is required and must be balanced within the member's benefit
structure.  Emphasis will be placed on continuity of care, assisting members
in obtaining access to care, and member education.  Participates in the
continuum of care that addresses the ongoing needs of the member served by
the care management process.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES: 

*	Assess patient's clinical presentation for medical necessity and
appropriateness of proposed evaluation/treatment goals.

*	Assess and  stabilize crisis call situations.

*	Authorize inpatient and/or outpatient treatment according to
company's stated criteria.

*	Clearly and completely document all initial and concurrent reviews,
including, but not limited to diagnosis, symptoms, interventions, goals and
plan for next review.

*	Close all cases according to the defined case closure procedure in a
timely manner, and in accordance with guidelines established by the
department Director.

*	Consult with Providers as needed, respond to provider questions with
regard to EAP or Managed Care cases.

*	Participate in training of other Care Managers as necessary. 
*	Complete EAP authorizations as assigned.

*	Perform Risk Management Activities as needed.

*	Attend weekly Administrative and Peer Review Committee meetings.

*	Perform special audits, projects, etc. as required.

*	Other duties as assigned.

REQUIREMENTS:


Education: 
Master's degree.

 

Certification/License:
Licensure as an LCSW, LMSW, LPC or LMFT

 

Experience:

Minimum 2 years post licensure clinical experience.

 

Knowledge, Skills & Abilities:

*	Knowledge of managed care and EAP principles and practices. 
*	Able to operate PC-based software programs including proficiency in
Word, Excel. 
*	Effective and professional communication skills, both in writing and
telephonically. 
*	Ability to assess a patient's clinical presentation and proposed
treatment plans according to company criteria. 
*	Manual dexterity.

OR
Any combination of academic education, professional training or work
experience, which demonstrates the ability to perform the duties of the
position.

 

Health Net, Inc. supports a drug-free work environment and requires
pre-employment background and drug screening.

 

Health Net and its subsidiaries are an Equal opportunity/Affirmative Action
Employer M/F/V/D.

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