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Health Services WellCare - Behavioral Health Careers

Behavioral Health Care Manager Job

Full Job Title: Behavioral Health Care Manager

Job Number: 1703956

Location: Bowling Green, KY

Date Posted: 8-28-2017

PLEASE NOTE: THIS IS A WORK FROM HOME OPPORTUNITY

COVERAGE AREA WILL BE FOR THE FOLLOWING COUNTIES: WARREN, BUTLER, LOGAN, SIMPSON, ALLEN, MONROE, METCALF, BARREN, HART & EDMONDSON"

Conducts comprehensive member psychosocial assessments through root cause analysis and performs clinical intervention through the development of a care management treatment plan specific to each member with high level acuity needs. Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability. Assess members to recommend activities and behavioral routines to meet the social and medical needs of members and their families. Provides support and/or intervention and assists members in understanding the implications and complexities of their current medical situation and/or overall personal care.


REPORTS TO: SUPERVISOR, BEHAVIORAL HEALTH

DEPARTMENT: KENTUCKY HEALTH SERVICES STATE

POSITION LOCATION: BOWLING GREEN, KY 42104

Essential Functions:

  • Assesses, plans, implements, monitors and evaluates options and services to meet complex psychosocial health needs of inpatient and outpatient members.
  • Manages a caseload in compliance with contractual obligations and WellCare standards.
  • Conducts comprehensive member assessments through root cause analysis based on referred member's needs and benefit plan eligibility, and performs clinical intervention through the development of a care management treatment plan specific to each member with high level acuity needs.
  • Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability.
  • Works towards achievement of optimal clinical and resource outcomes.
  • Monitors and evaluates effectiveness of care plan and modifies plan as needed.
  • Supports member access to appropriate quality and cost effective care.
  • Coordinates with internal and external resources to meet identified needs of the member's care plan and collaborates with providers.
  • Acts as a liaison and member advocate between the member/family, physician and facilities/agencies.
  • Provides clinical consultation to physicians, professional staff and other teams members/supervisors to provide optimal quality patient care and effective operations.
  • Interacts continuously with members, family, physician(s), and other resources to determine appropriate behavioral action needed to address medical needs.
  • Reviews benefits options, researches community resources, trains/creates behavioral routines and enables members to be active participants in their own healthcare.
  • Ensures members are engaging with their PCP to complete their care management treatment plan or preventive care services.
  • Assists in obtaining benefits for members through community resources when benefits are exhausted or not available.
  • Performs other duties as assigned.
Candidate Education:
  • Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position is required
Candidate Experience:
  • 2 years of experience in behavioral health management and/or acute behavioral health care setting focusing on outpatient/inpatient utilization, case management and discharge planning is required
  • 1 year of experience in current case management as a licensed professional is required
  • Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs is required
  • Experience in a managed care environment is preferred
Candidate Skills:
  • Ability to work independently, handle multiple assignments and prioritize workload
  • Ability to multi-task
  • Demonstrated time management and priority setting skills
  • Demonstrated interpersonal/verbal communication skills Communicates effectively in person and by phone
  • Ability to create, review and interpret treatment plans
  • Ability to effectively present information and respond to questions from families, members, and providers
  • Knowledge of healthcare delivery
  • Knowledge of community, state and federal laws and resources
  • Demonstrated written communication skills
  • Demonstrated customer service skills
  • Ability to effectively present information and respond to questions from peers and management
  • Demonstrated problem solving skills
Licenses and Certifications:
A license in one of the following is required:
  • Master's level independent or non-independent license is required is required
  • Licensed Clinical Social Worker (LCSW) LSW, LCSW, LMHC, LPC, LMFT, PsyD is required
  • Licensed Clinical Mental Health Counselor (LCMHC) is required
  • Licensed Clinical Professional Counselor (LCPC) is required
  • Licensed Clinical Marriage & Family Therapist (LCMFT) is required
  • Licensed Clinical Psychologist (LCP) is required
  • Licensed Master Social Work (LMSW) is required
  • Certified Social Worker (C-SW) is required *LI-RG1
  • Required Acute Care Nurse Practitioner (APRN) (ACNP-BC)
  • Required Other NJ Only - post graduate (master level) LSW
Technical Skills:
  • Proficient in Microsoft Office including MS Outlook, MS Word and MS Excel is required
  • Knowledge of or the ability to learn company approved software such as EMMA, CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties is required
  • Healthcare Management Systems (Generic) is required

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Last Updated On: 12/9/2015