$80K - $100K(Ladders Estimates)
The Behavioral Health Care Manager anticipates and coordinates care / services / health education for targeted member populations with chronic disease conditions or high cost specialty care. She/he demonstrates knowledge of complex case management, prognosis and outcomes, and is responsible for ensuring that member goals are achieved within a specified time period based upon individual needs, reasonable expectations and well-documented outcomes.
Bachelor's Degree from an accredited school of nursing/related field; or RN currently enrolled in a bachelors program with a documented plan for completion. Equivalent experience may be substituted for a degree.
Master's Degree in Social Work is also accepted.
Demonstrated clinical expertise.
Knowledge of health care and managed care delivery systems.
Standards of medical practice.
Insurance benefit structures and related legal/ medical issues.
Utilization management and quality improvement processes.
Clinical, satisfaction and financial outcomes.
Ability to work in a dynamic, team-oriented environment and demonstrate positive relationship building.
Effective verbal/ written communication.
Ability to affect change.
Ability to perform critical analysis, plan and organize effectively.
Ability to promote member/family autonomy.
Business acumen so that health benefits and member/provider satisfaction are maximized while solidifying the program's viability through cost effective intervention.
Additionally for Case Manager, Complex:
Attitude and skills that facilitate patient engagement in their health care.
D. Required Licensure, Certification, Etc.:
Current registered nurse licensure in the state of Maryland or LCSW-C.
Certification in case management (CCM) preferred.
E. Work Experience:
Minimum five (5) years clinical practice.
Three (3) years case management. Managed care experience preferred.
Valid Through: 2019-10-21