About the role

  • Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substance use disorder.
  • Evaluates the needs of the member via phone or in-home visits related to the resources available, and recommends and/or facilitates the care plan/service plan for the best outcome, which may include behavioral health and social determinant needs.
  • May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources.
  • Develops ongoing care plans for members with high level acuity and works to identify providers, specialists, and community resources needed for care including mental health and substance use disorders.
  • Coordinates as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members.
  • Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs.
  • Facilitates care coordination and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services.
  • Collects, documents, and maintains member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
  • Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs.
  • Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner.
  • Performs other duties as assigned. Complies with all policies and standards.

Requirements

  • Required Licensure: LCSW, LMFT, LPC or RN based with Behavioral Health experience is required
  • Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2 – 4 years of related experience
  • Preferred Experience: Clinical Behavioral Health and/or Case Management experience in Mental Health Authorities (MHAs), Local Intellectual Developmental Disabilities Authorities (LIDDA), Inpatient or Outpatient Psychiatric or Behavioral Health hospitals, Substance Abuse Recovery Treatment centers, community-based Counseling/ Mental Health environments, or Behavioral Health Managed Care organizations
  • Experience conducting intake assessments and care coordination of formal healthcare and behavioral services
  • Experience working with adults (18 – 65), legal guardians, or legal representatives of minors is a major plus.
  • Role requires strong adaptability, flexibility, and resiliency skills.
  • Must have proficient computer skills with Microsoft and Video Conferencing applications (e.g. Outlook, Word, Excel, ZOOM, MS Teams)
  • Must be able to work independently with minimal supervision.
  • Bilingual – Spanish and English is a plus but not required.

Benefits

  • competitive pay
  • health insurance
  • 401K and stock purchase plans
  • tuition reimbursement
  • paid time off plus holidays
  • flexible approach to work with remote, hybrid, field or office work schedules

Job title

Care Manager

Job type

Experience level

JuniorMid level

Salary

$55,100 - $99,000 per year

Degree requirement

Postgraduate Degree

Location requirements

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