Job Description

Your Role

Reporting to the Manager, Care Management- Behavioral Health, the Behavioral Health Care Management Clinician, Senior helps members with behavioral health needs navigate the health care system for linkages to behavioral health providers, treatment, and programs. The Behavioral Health Care Manager will offer support in assessing members' emotional and psychological well-being and providing resource coordination, crisis intervention, substance abuse, and with any behavioral or mental health referrals. The Behavioral Health Care Management Clinician, Senior will be available to physicians and nurse care managers as consultants for patients with complex psychosocial needs. The position requires an intensive focus on crisis intervention and counseling, problem-solving and conflict resolution, patient and family management, interdisciplinary collaboration, psychosocial assessments, education, advocacy, and community resource linkages.

Responsibilities

Your Work

In this role, you will:

• Collaborate with case managers and other team members to complete member assessments related to social and resource needs to support member access to services
• Collaborate with service coordination staff and act as liaison to ensure a timely and accurate response to member needs
• Collaborate with providers to support members' treatment plan and care needs
• Recognize the client's right to self-determination as it relates to the ethical principle of autonomy, including the client/family's right to make informed choices that may not promote the best outcomes, as determined by the healthcare team
• Assess members health behaviors, cultural influences and clients belief/value system and evaluates all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriers
• Efficiently manages and maintains a caseload of members for behavioral health care coordination and or BH case management for persons experiencing severe and persistent mental illness.
• Maintains an active workload in accordance with National Care Manager performance standards.
• Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.
• Interacts with Utilization department and Physician Advisors to discuss clinical questions and concerns regarding specific cases.
• Coordinates services with state and community programs on behalf of the member, particularly when the member is unable to effectively do so independently
• As a mandated reporter, files and follows-up on reports made to the appropriate government agency (e.g., Adult Protective Services, Child Protective Services, etc.)
• Actively participates in Interdisciplinary Team Meetings and case consultations with Licensed Manager.

Qualifications

Your Knowledge and Experience

• Current unrestricted CA License (LCSW, LMFT, LPCC, Registered Nurse (RN), or PsyD by the Board of Behavioral Health Sciences required
• RN Requires an associate's degree or BSN preferred
• Master's degree required for non RN-licensure
• Requires at least five (5) years of prior relevant experience, including three (3) years of experience in behavioral health.
• Certified Case Manager preferred
• Experience conducting thorough psychosocial assessments, developing care plans and providing necessary interventions identified during assessment with complex client populations that may have, among other things, inadequate coping skills, severe emotional disorders, developmental disabilities, mental illnesses, and/or unstable housing
• Considerable knowledge of a wide range of psychosocial challenges and familiarity with behavioral health diagnoses and treatment
• Proficient with computer programs such as Microsoft Excel, Outlook, Word, and PowerPoint

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• For most teams, this means coming into the office two days per week.
• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail.