**Experienced Care Manager – Behavioral Health Treatment (BHT) and Applied Behavior Analysis (ABA) Services – Remote Opportunity at blithequark**

Are you a compassionate and detail-oriented professional with a passion for delivering exceptional care to individuals in need? Do you thrive in a dynamic and fast-paced environment where no two days are ever the same? If so, we invite you to join blithequark as an Experienced Care Manager, where you will play a vital role in shaping the lives of our members through our Behavioral Health Treatment (BHT) and Applied Behavior Analysis (ABA) services. **About blithequark** blithequark is a leading healthcare organization dedicated to providing innovative solutions and exceptional care to our members. Our mission is to empower individuals to live their best lives, and we are committed to fostering a culture of dignity, respect, and compassion. As a remote Care Manager, you will be part of a dynamic team that is passionate about delivering high-quality care and making a meaningful impact in the lives of our members. **Job Overview** As an Experienced Care Manager, you will be responsible for overseeing and evaluating BHT and ABA services for eligible members, ensuring that they receive the highest quality of care based on medical necessity. You will work closely with our team to assess requests for medical appropriateness, verify referrals, and communicate decisions clearly to our members and providers. Your attention to detail, strong analytical skills, and ability to navigate complex medical information will be essential in this role. **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. **Required Skills** * Establish and nurture strong relationships with colleagues and external partners from diverse backgrounds. * Work autonomously while exercising sound judgment in decision-making. * Communicate effectively in both verbal and written formats. * Adapt to a flexible work schedule that may include evenings and weekends. * Exhibit strong organizational, analytical, problem-solving, and project management skills. * Prosper in a fast-paced work environment while managing multiple tasks simultaneously. * Inspire and motivate team members and external committees. * Demonstrate proficiency in Microsoft Office Suite (Word, Outlook, Excel, PowerPoint) and related applications. **Qualifications** * A Master's degree in psychology, social work, counseling, or a related field, along with 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). **Career Growth Opportunities** At blithequark, we value your professional development and offer numerous opportunities for skill enhancement and career advancement within the healthcare sector. Whether you're looking to expand your expertise in BHT and ABA services or explore new areas of interest, we provide the support and resources you need to succeed. **Company Culture and Values** We foster a collaborative environment that emphasizes high-quality performance and member service, nurturing a culture of dignity and respect. Our team is passionate about delivering exceptional care and making a meaningful impact in the lives of our members. As a Care Manager, you will be part of a dynamic team that is dedicated to excellence and committed to making a difference. **Networking and Professional Opportunities** In this role, you will have the chance to collaborate with a dedicated team, enhancing your professional network and skillset in the healthcare community. You will also have access to ongoing training and development opportunities, ensuring that you stay up-to-date on the latest best practices and industry trends. **Compensation and Benefits** * 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. **Employment Type** Full-Time If you're a motivated and compassionate professional with a passion for delivering exceptional care, we invite you to join our team as an Experienced Care Manager. Apply today and take the first step towards a rewarding career with blithequark! Apply Now! Apply for this job