Utilization Management Care Manager – Riverside Health System – Hampton, VA

Job Summary: This position must demonstrate by education and/or training a background in the assessment and treatment of adolescents and adults seeking psychiatric and/or chemical dependency treatment. The position performs Utilization Review activities to include pre-authorizations review of admissions and continued stay reviews for medical necessity using approved criteria completes all medical record documentation and other written assignments (CM Screening Form) outlined in the department/hospital policy. The Care Manager serves as the treatment team coordinator and court services liaison calls treatment team completes multidisciplinary treatment team documents according to policy and provides treatment team with medical necessity information. The Care Manager is the discharge planner and ensures patients/residents are provided age appropriate aftercare plans. Continuity of care is ensured by providing copies of the aftercare plan to providers. In addition the Care Manager identifies opportunities to improve quality and decrease cost in all areas of responsibility through an interdisciplinary approach and maintains positive interpersonal relations through professional interactions and communications.

Riverside Behavioral Health Center offers the most comprehensive range of behavioral health programs on the Virginia Peninsula. An established mental health care provider in Hampton Roads since 1983, Riverside Behavioral Health Center provides psychiatric and chemical dependency services to children, adolescents and adults on an outpatient and inpatient basis. We offer a variety of services such as Inpatient Adult Services, Inpatient Child and Adolescent Services, Adolescent Residential Services and Outpatient Services, to individuals who experience emotional, psychological and behavioral problems. Individual, family and group therapy, recreation therapy, art therapy, life skills groups, and medication management are key components of the programs we provide.

Licensed RN or Masters degree (MSW, MS, MA, Med) in Social Work, Counseling, Psychology, or related field required.

Clinical Internship in a hospital setting or two years clinical experience preferred.

Current BLS is required within 30 days of hire. If RN, must have licensure with the State of Virginia.