Behavioral Health Care Manager I managing psychiatric and substance abuse treatment through telephonic or written review. Ensuring access to quality behavioral healthcare under UM Clinical Guidelines and contract standards.
About the role
- Case Manager in the Inclusa/Humana team, providing social service care management for Members in Wisconsin. Assessing needs, coordinating services, and enhancing members' quality of life.
Responsibilities
- Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP).
- Coordinate services that address members’ health and safety needs, ensuring support is provided in the least restrictive environment in accordance with the MCP.
- Collaborate continuously with a Field Care Nurse (RN) to review and update care plans and address members’ evolving needs.
- Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member’s residence.
- Schedule, conduct, and document quarterly in-person visits and maintain monthly contact with members by phone.
- Identify, arrange, and monitor support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs.
- Engage in clear and empathetic communication with members to better understand their needs, support informed decision-making, and ensure cost-effective service delivery.
- Prioritize safety by continuously evaluating risk factors and providing education to members to promote overall health and wellness.
- Maintain accurate and timely documentation of activities, including case notes, service authorizations, and updates to the Member Care Plan.
- Foster direct collaboration with service providers, natural supports, and other community partners to enhance member outcomes.
- Travel is necessary to conduct member visits and fulfill role responsibilities.
Requirements
- Four-year bachelor’s degree in the Human Services or related field with one (1) year of experience working with at least one of the Family Care target populations OR a four-year bachelor’s degree in any other field with three (3) years’ related experience working with at least one of the Family Care target populations
- Case Management experience
- Experience with electronic case note documentation and experience with documenting in multiple computer applications/systems
- Knowledge of community health and social service agencies and additional community resources
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
- many other opportunities
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