CARE MANAGER in Miami, FL at Beacon Health Options

Date Posted: 3/14/2018

Job Snapshot

Job Description


We are currently seeking a dynamic Utilization Review Clinician to join our team at our office in Miami, Florida.  The Utilization Review Clinician performs authorization determinations of mental health and substance use services provided in inpatient, outpatient and/or diversionary care settings.   

Position Responsibilities:

  • Performs telephonic or paper case review and authorization determinations for certification of admissions into Behavioral Health or Substance Abuse treatment at any level of care.
  • Determines appropriate level of care related to mental health and substance use treatment for members based on Beacon’s medical necessity level of care criteria
  • Consults with Beacon’s Physician Advisors (PA) when requests for services do not meet medical necessity criteria
  • Interacts with Physician Advisors to discuss clinical/authorization questions, alternative treatment options and concerns regarding specific cases
  • Provides information to members and providers regarding mental health and substance abuse benefits and community treatment resources when appropriate
  • Recognizes quality of care issues and reports them appropriately through internal and external processes.
  • Interacts with providers and facilities in a professional, respectful manner
  • Complies with all Beacon’s policy guidelines, external regulatory requirements and URAC/NCQA accreditation standards.

Position Requirements:

Education: Required to be educated in current principles, procedures and knowledge of behavior health.  Master’s degree or higher in a health related field preferred.

Licensure:  Current, valid, and unrestricted licensed behavioral health clinician and practice within the scope of their licensure with a minimum of 2 years behavioral health experience. 

Relevant Work Experience:   A minimum of 2 years behavioral health experience

Knowledge, Skills & Abilities:

  • Keen attention to detail
  • Able to multitask with ease
  • Moderate skill level in MS Office environment (Outlook, Word, Excel, PowerPoint)
  • Good written and verbal communication skills
  • Desire to continually improve problem resolution skills
  • Team player with an ability to work under pressure


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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled




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