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UM Care Manager in Grand Rapids, MI at Beacon Health Options

Date Posted: 5/24/2019

Job Snapshot

Job Description

About the Position:

Beacon Health Options is currently seeking a dynamic Utilization Management Care Manager to join our growing team in Grand Rapids, MI! The UM Care Manager 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
  • Demonstrates thorough understanding of product lines and benefit structure for all contracts assigned
  • Handles crisis calls when needed
  • Participates in rounds with medical director or supervisor to discuss clinical determinations of cases

Position Requirements:

  • Education: 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:  2 years behavioral health experience required
  • Knowledge, Skills & Abilities:
    • Keen attention to detail and ability 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

To Apply:

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email ( Only candidates who have applied for an open position through our Careers page ( will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.




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