Behavioral Health Care Manager focusing on person-centered care for IEHP members. Provide high-quality care management and collaboration with Members and stakeholders.
Responsibilities
Establish and continuously model supportive and collaborative relationships with members, colleagues, and external partners.
Model the highest ethical behavior in care for Members, as well as in relationships with co-workers, Leaders, internal, and external partners.
Model commitment to continuous quality improvement by engaging in quality improvement initiatives and projects, such as by identifying and addressing HEDIS gaps, and by identifying, developing, and testing new practices for improving the outcomes of the Enhanced Care Management team.
Participates in Health Plan staff meetings, trainings, committee meetings, or other activities as needed or as directed by Leadership Team Members.
Working in a lead training capacity by providing formal and informal clinical training and other learning and development activities to support department Team Members on behavioral health conditions, including treatments and evidence-base for treatment (within areas of expertise/scope) as well as provide onboarding and ongoing training to department Team Members.
Promote a collaborative and effective working environment within the department or those outside BH discipline by engaging in evidenced-based communication strategies (such as Motivational Interviewing) when discussing responsibility/sharing of tasks, effectively resolving conflicts as they arise, and collaborating on Member case discussions to provide integrated care to IEHP members.
Participate in committees, conferences, and any other meetings as required or directed by department managers or directors.
Responsible for primarily working with a caseload of Members with behavioral health needs.
Advocate for Members to receive the highest quality care, in a timely manner, within IEHP’s network by referring to appropriate internal partners such as behavioral health, Enhanced Care Management, and complex care management.
In conjunction with department leadership, the Licensed Behavioral Health Care Manager is responsible for providing consultation for the non-licensed Members of the team when discussing tasks of a clinical nature.
Responsible for engaging with Members to provide effective care management, both in-person and on the phone, including linkage to resources and support in transitions of care, in a manner that utilizes evidence-based approaches (such as Motivational Interviewing) that promotes collaboration between the Member and his or her medical/behavioral team, facilitating member self-efficacy and self-management to improve the Member’s ability to manage their own health, and all other activities associated with high quality, evidenced-based care management.
Ensures documentation is accurate and in compliance with regulatory requirements and accreditation standards.
Assist Members with care coordination needs, including, but not limited to the following: Conduct comprehensive, holistic assessment both telephonically as well as in person (facility or home visits).
Assimilate assessment information to assist, in collaboration with the ITC Team and the facility, in developing a discharge plan or an individualized care plan (ICP).
Communicate ICP or discharge plan with Member, approved family or caregiver and other Members of the care team.
Coordinate with internal and external health partners to support Members’ comprehensive care needs.
Assists with the coordination of medical and behavioral health access issues with PCP offices, specialists, and ancillary services.
Participate in inter/transdisciplinary care team meetings to share information, update and inform care plan.
Participate and lead (as necessary) care transition plan responsibilities.
Engage in proactive, member-centered utilization and quality review of Behavioral Health services by members.
Provide crisis intervention to individuals, as well as providing support and clinical guidance to others who engage in this work.
Responsible for any other duties as required to ensure successful care management processes and Member outcomes.
Provide transitional care services to Members transitioning from one care setting to the next such as assisting the Member with PCP appointments, transportations, and coordination of DME and home health.
Support Member through all care transitions by making outreach to ensure all care needs are met before closing the Member out to transitions of care. providing care coordination, linkage to resources, and facilitating Member self-efficacy and self-management.
Perform any other duties as required to ensure Health Plan operations and department business needs are successful.
Requirements
Minimum of three (3) years of experience performing or facilitating Behavioral Health/Medical Social Work services
Experience in motivational interviewing and/or other evidenced-based communication strategies
Experience working successfully within a team, and experience in developing and maintaining effective relationships with both clients and coworkers is mandatory
Possession of an active, unrestricted, and unencumbered license in a Social Services related field issued by the California Board of Behavioral Sciences required (LCSW or LMFT preferred)
Behavioral Health/Medical Social Work services experience in a health clinic psychiatric hospital, medical facility, or health care clinic strongly preferred
Experience in clinical services, both mental health and substance use preferred
Master’s degree in Social Work or related field from an accredited institution required
Must have a valid California Driver's License
Familiarity with providing Behavioral Health Care and discharge planning is required
Knowledgeable and skilled in evidenced-based communication such as Motivational Interviewing, or similar empathy-based communication strategies
Understanding of and sensitivity to multi-cultural communities
Deep understanding and knowledge of mental health and substance use conditions, including both acute and chronic management
Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both
Must have knowledge of whole health and integrated principles and practices
Bilingual (English/IEHP Threshold Language) – written and verbal is highly preferred
Highly skilled in interpersonal communication, including conflict resolution
Effective written and oral communication skills, as well as reasoning and problem-solving skills
Skillful in informally and formally sharing expertise
Must have the resiliency to tolerate and adapt to a moderate level of change and development around new models of care and care management practices
Proficient in the use of computer software including, but not limited to, Microsoft Word, Excel, PowerPoint
Demonstrated proficiency with all electronic medical management systems (e.g., Cisco, MHK/Care Prominence, MediTrac, SuperSearch and Web Portal) is preferred
Benefits
Competitive salary
CalPERS retirement
State of the art fitness center on-site
Medical Insurance with Dental and Vision
Life, short-term, and long-term disability options
Career advancement opportunities and professional development
Wellness programs that promote a healthy work-life balance
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