Clinical Care Reviewer (County Care Management Manager, Local Government) - Fayette County

Step into a role where your clinical expertise fuels meaningful change! Fayette County Behavioral Health Administration has an immediate opening for a Clinical Care Reviewer. In this role, you will have the opportunity to support individuals in need of psychiatric, behavioral health, as well as drug and alcohol treatment services. Join us in our mission of enriching lives by providing choice and access to resources that encourage hope, independent, and recovery.

As a Clinical Care Reviewer, you will be responsible for gathering essential demographic and clinical information by phone to authorize services and make appropriate referrals to licensed mental health and addiction professionals. You will be guiding consumers through their benefits, treatment options, the managed care system, and available community resources while maintaining accurate, timely documentation in automated systems and client records. Work also involves reviewing the medical appropriateness of behavioral health and substance use cases and, in consultation with a supervisor, issuing certification decisions.

As a key advocate for consumers and families, you will coordinate care with other care managers, complete referral and case documentation, conduct follow-ups with consumers and providers, and participate in customer service assessment activities. You will also prepare required reports in accordance with federal, state, and county guidelines. The role offers opportunities for ongoing professional development through clinical rounds, seminars, and training sessions to maintain licensure and clinical credentials.

Work Schedule and Additional Information:

• Full-time employment
• Work hours are 8:30 AM to 4:30 PM, Monday - Friday, with a 30-minute lunch.
• Telework: You will not have the option to telework in this position.
• Salary: In some cases, the starting salary may be non-negotiable.
• You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices.

QUALIFICATIONS

Minimum Experience and Training Requirements:

• Two years of professional mental health clinical experience and possession of an active license to practice as a Registered Nurse issued by the Pennsylvania State Board of Nursing; or
• A master's degree in social work, psychology, nursing, or counseling and two years of professional mental health clinical experience.

Special Requirements:

• This position requires an active license issued by the Pennsylvania Bureau of Professional and Occupational Affairs in one of the following areas:
  • Social Work
    
    • 20001-Social Worker
      
    • 20010-Clinical Social Worker
      
    • 20020-Marrage and Family Therapist
      
    • 20030-Professional Counselor
  • Psychology
    
    • 26001-Psychologist
      
  • Nursing
    
    • 18001-Registered Nurse
      
    • 18040-Certified Registered Nurse Practitioner
      
    • 18170-Clinical Nurse Specialist

Other Requirements:

• You must meet the PA residency requirement. For more information on ways to meet PA residency requirements, follow the link and click on Residency Guidelines.
• Hiring preference for this vacancy may be given to candidates who live within Fayette County. If no eligible candidates who live within Fayette County apply for this position, candidates who reside in other counties may be considered.
• You must be able to perform essential job functions.

Legal Requirements:

• This position falls under the provisions of the Child Protective Services Law.
  • Under the Law, a conditional offer of employment will require submission and approval of satisfactory criminal history reports including, but not limited to, PA State Police clearance, PA Child Abuse history clearance, and FBI Fingerprint clearance.

How to Apply:

• Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education).
• If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.
• Your application must be submitted by the posting closing date. Late applications and other required materials will not be accepted.
• Failure to comply with the above application requirements may eliminate you from consideration for this position.
• All application materials and interview responses must reflect the applicant's own experience, qualifications, and work. Applicants may use generative AI tools for preparation purposes only. Use of AI to misrepresent or falsify information, or to assist during interviews, is not permitted. Review the Guidance for Generative AI Tools & Job Seekers for additional information.

Veterans:

• Pennsylvania law (51 Pa. C.S. *7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to www.pa.gov/agencies/employment/how-to-apply.html and click on Veterans.

Telecommunications Relay Service (TRS):

• 711 (hearing and speech disabilities or other individuals).

If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.

The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.

• Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam).
• Your score is based on the detailed information you provide on your application and in response to the supplemental questions.
• Your score is valid for this specific posting only.
• You must provide complete and accurate information or:
  • your score may be lower than deserved.
  • you may be disqualified.
• You may only apply/test once for this posting.
• Your results will be provided via email.