Behavioral Health Case Manager I
Elevance Health
Care Manager
Centene Corporation
full-time
Posted on:
Origin: • 🇺🇸 United States • Illinois
Visit company websiteSalary
💰 $55,100 - $99,000 per year
Job Level
JuniorMid-Level
About the role
- Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substance use disorder
- Evaluates the needs of the member via phone or in-home visits related to the resources available, and recommends and/or facilitates the care plan/service plan for the best outcome
- May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources
- Develops ongoing care plans for members with high level acuity and works to identify providers, specialists, and community resources needed for care including mental health and substance use disorders
- Coordinates as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members
- Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs
- Facilitates care coordination and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services
- Collects, documents, and maintains member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
- Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs
- Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
- Performs other duties as assigned. Complies with all policies and standards
Requirements
- Must reside in one of the following Illinois counties: Clay, Crawford, Effingham, Fayette, Jasper, Jefferson, Lawrence, Marion, Perry, Richland, Alexander, Edwards, Franklin, Gallatin, Hamilton, Hardin, Jackson, Johnson, Massac, Pope, Pulaski, Saline, Union, Wabash, Wayne, Wayne City, White, or Williamson
- Graduate degree and independently licensed behavioral health clinician (e.g. LCSW, LCPC, PsyD) in Illinois OR Bachelor’s Degree and IL RN licensure
- Accredited School of Nursing and 2 – 4 years of related experience (for RN option)
- For Illinois Youth Care plan only: Graduate degree and independently licensed behavioral health clinician (e.g. LCSW, LCPC, PsyD) in Illinois OR Bachelor’s Degree and IL RN licensure
- Must reside in IL required
- Ability to perform telephonic, digital, home and/or other site visits outreach
