• The salary range for this position is $80,000 - $83,000 / yr
• This is a Full-time position
• Health Insurance Plans
• Flexible Spending Account Programs
• Management or Union Benefits
• Leave Benefits
• Special Leave of Absence Coverage (SLOAC)
• Retirement Savings Plans
• Additional Savings Plan
• Transit Benefit
• Direct Deposits
• Municipal Credit Union (MCU)

• Must have a current valid unrestricted LCSW, LMSW, or LMHC NY State License
• Must have a master’s degree in Social Work or Mental Health Counseling
• Must have a minimum of 3 years of Behavioral Health (Serious Mental Illness & Substance Use Disorder) experience in managed care utilization review, quality assurance, and discharge planning. (Experience working in a Psychiatric Hospital Inpatient and/or Outpatient setting is preferred)
• Must have experience in managing care for children/youth including high-risk groups, such as children with or at risk for SUD, children with SED, with co-occurring major, mental disorders, and SUD, who are involved in multiple services systems (education, justice, medical, welfare, and child welfare).
• Must have knowledge of New York State child-serving systems.
• Experience working with the community and family-based services is preferred.
• Previous experience within the Integrated Collaborative Care Model Approach is preferred.
• Knowledge and experience in children’s physical health and BH services, Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services, and social service programs, including but not limited to Health Homes, OPWDD (Office for People with Developmental Disabilities), OCFS (Office of Child and Family Services) is preferred.
• Must have an experience with chronic condition management, particularly asthma, Diabetes, HIV, and Heart Disease
• Knowledge of psychopharmacology, Psyckes, E-Paces, LOCADTR, InterQual, Locus/Calocus, HCS (UAS) MAPP is preferred.
• Must have strong interpersonal and assessment skills, and the ability to remain calm and poised with challenging providers.
• Medical Background & Bilingual is preferred
• Previous experience with hospitals and other large volume providers to address HEDIS/QARR initiatives is preferred.
• Must have exceptional organizational and communication skills.

• Performs telephonic review for diversionary and outpatient services using NYS criteria for HCBS services.
• Contributes to UM program goals and objectives by containing health care costs and promoting diversionary services to avoid unnecessary admissions by maintaining a high-quality medical delivery system through departmental UM procedures.
• Collects all pertinent clinical information and documents within our care and utilization management
• Promotes alternative care programs, researches available options including eligibility for waiver programs, and considers costs and appropriateness of patient placement in collaboration with health plan members.
• Communicates with Medical Director regarding all outpatient/diversionary requests for health care services that do not meet medical necessity or appropriate level of care and out-of-network transfer issues.
• Recommends, coordinates, and educates providers regarding alternative care options.
• Educate providers on medication and treatment compliance while also promoting the use of Long Acting Injectables
• Enlist existing provider network in promoting first-episode psychosis treatment.
• Educate providers to alternate treatment services being promoted by Health + Hospitals in lieu of Inpatient Detox.
• Attends and prepares for Integrated Clinical Rounds meetings which focus on newly enrolled, frequently admitted, high-utilizing at-risk children/youth.
• Maintains an active role in assuring the continuity of care for all members who have been admitted through collaboration with BH UM CM, early discharge planning, and working with hospital Social Worker discharge planning staff, Health Homes, and community providers.
• Identifies potentially catastrophic, high-risk medical and behavioral cases, and Transitioning Aged Youth (TAY) and coordinates with Children’s Nurse CM and Foster Care Liaison, as indicated, to provide an integrated approach to case management.
• Identifies and communicates all potential quality of care concerns to the Director in a timely manner.
• Contributes to the company’s corporate goals through ongoing active team participation, offering input and assistance with the development and delivery of education and training.
• Performs other appropriate BH UM/CM duties as assigned by the Medical Director, Director of Children’s Special Services, and/or the BH HARP Department Management and participates in other special projects, including, but not limited to, monthly audit review and preparation, quality improvement, community health education, facility/provider relations, and marketing activities.
• Promotes a multi-generational approach to care management and provides education, referrals, and coaching to members’ families to foster a supportive environment.
• Provides telephone triage and crisis intervention to callers and, when necessary, assists with ensuring members have access to local services and resources.

We are committed to our core values: integrity, honesty, and transparency Finding a new position as a physician or allied health professional or filling a critical vacancy in your practice, clinic, hospital, or skilled care facility can be stressful and time-consuming. At Greenlife our mission is to make this process easier for you and help you through all the steps necessary to find that perfect new position or the healthcare professional to round out your team. We understand that every situation is different and our approach reflects that: we value personalized interaction with job seekers and employers, our searches are customized not cookie-cutter and our results speak for themselves: Happy job seekers and employers who found the right professional match through our services.