Behavioral Health Specialist*

Coordinates the behavioral health and socioeconomic services of Managed Long Term Care (MLTC) members across the continuum of illness. Provides support and guidance to the MLTC personal care managers to coordinate identified behavioral health services, and assists in educating members of implications and complexities of behavioral health conditions and/or overall personal care. Collaborates with the interdisciplinary team to provide up-to-date educational and resource information designed to aid members in making informed decisions about their independent living options. Contributes to the ongoing development and delivery of the overall behavioral health program; including, but not limited to, training programs for internal and external partners (such as Limited Mental Health Assisted Living Facilities)

Reports to: Director, Product Operations

Department: Population Health Solutions

Essential Functions:

  • Assists to identify programs and activities to meet the social and behavioral health needs of MLTC members.
  • Proactively identifies, strategizes and solutions program opportunities to enhance the overall program.
  • Provides support to care managers in the coordination of behavioral health services to meet care plans goals for members and caregivers by utilizing behavioral health and social service expertise to meet members’ need for alternative services, resources, and third party intervention.
  • Assists in identifying at-risk members and developing care plans to prevent further psychological/physical deterioration, relapse, or morbidity in conditions,
  • Maintains current information related to behavioral health issues and conditions relevant to the long-term care population to assist care managers, providers, and members/caregivers in addressing and managing such conditions.
  • Assists members to change behaviors and to locate and access interpersonal, family and community resources that will make it easier to manage their health and promote independent living. Reviews benefits options, researches community resources, coordinates services, trains behavioral routines and enables members to be active participants in their own healthcare.
  • Assists in developing and delivering training programs to internal and external partners including LMH- ALF or other residential settings, as indicated
  • Identifies and assists care managers in coordinating s community resources with emphasis on the development of natural support system and promoting independent living. Coordinates benefits, regulations, laws and public entitlement programs.
  • Acts as a liaison and member advocate between the member/family, physician, facilities, and State agencies.
  • Assists in obtaining services for members through community resources when benefits are exhausted or not available.
  • Assists with identifying and implementing new or expanding behavioral health services initiatives.
  • Helps establish process improvements leading to best practice and assist in implementing changes.
  • Trains, mentors and provides guidance to regarding policy and procedure, systemic tools, behavioral health services and education (e.g., dementia and Alzheimer’s related disorders), resources and BH service coordination.
  • Performs other duties as assigned.
Additional Responsibilities:
    Candidate Education:
    • Required A Bachelor's Degree in Social Work, Psychology, Counseling, Rehabilitation, Psychology or other relevant field
    • Preferred A Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, Psychology or other relevant field
    Candidate Experience:
    • Required 4 years of experience in a healthcare environment, residential setting (e.g., Assisted Living Facility, Nursing Facility) or behavioral health setting with responsibilities of identifying biopsychosocial needs and client care coordination responsibilities, and managing.
    • Preferred 2 years of experience in a managed care environment
    Candidate Skills:
    • Intermediate Ability to work independently
    • Intermediate Demonstrated interpersonal/verbal communication skills
    • Intermediate Ability to create, review and interpret treatment plans
    • Intermediate Ability to drive multiple projects
    • Intermediate Ability to work within tight timeframes and meet strict deadlines
    • Intermediate Ability to effectively present information and respond to questions from families, members, and providers
    • Intermediate Ability to effectively present information and respond to questions from peers and management
    • Intermediate Demonstrated problem solving skills
    • Intermediate Demonstrated written communication skills
    • Intermediate Demonstrated written communication skills
    • Intermediate Knowledge of community, state and federal laws and resources
    • Intermediate Knowledge of healthcare delivery
    Licenses and Certifications:
    A license in one of the following is required:
    • Required Other Licensed in one of the following:
    • Required Licensed Clinical Social Worker (LCSW)
    • Required Licensed Mental Health Counselor (LMHC)
    • Required Other Registered Nurse (RN) with Behavioral Health experience
    Technical Skills:
    • Required Intermediate Microsoft Excel
    • Required Intermediate Microsoft PowerPoint
    • Required Intermediate Microsoft Outlook
    • Required Intermediate Microsoft Word
    • Required Intermediate Other Knowledge of or the ability to learn company approved software such as Care Central, CRMS, Paradigm, InterQual, Sidewinder and other software in order to perform job duties.
    Languages:

      About us
      Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans to families, children, seniors and individuals with complex medical needs. WellCare is a Fortune 500 company, and in 2018, was recognized as a Fortune "World's Most Admired Company", ranking in the top five among the health insurance and managed care industry-a testament to the hard work and dedication of the company's nearly 9,000 associates who each day live WellCare's values and deliver on its mission to help its members live better, healthier lives. The company serves approximately 4.4 million members nationwide as of Dec. 31, 2017. For more information about WellCare, please visit the company's website at www.wellcare.com. EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.