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
Requirements
Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing
2 – 4 years of related experience
Licensed Behavioral Health Professional - LCSW, LPC, LMFT, or RN with BH experience is required based on state contract requirements
4+ years of verifiable employment in Mental Health Authorities (MHAs), Inpatient or Outpatient Psychiatric or Behavioral Health hospitals, Substance Abuse Recovery Treatment centers, or community-based Counseling/ Mental Health environments
Experience conducting comprehensive psychological assessments and care coordination of formal healthcare/behavioral services with adults Medicaid recipients (18 – 65)
Experience managing high volume caseloads
Strong adaptability, flexibility, and resiliency skills
Proficient computer skills with Microsoft and Video Conferencing applications (e.g. Outlook, Word, Excel, ZOOM, MS Teams)
Work independently with minimal supervision
Bilingual – Spanish and English is a plus but not required
Benefits
competitive pay
health insurance
401K and stock purchase plans
tuition reimbursement
paid time off plus holidays
flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
care managementpsychological assessmentscare coordinationmental healthsubstance use disorderhigh volume caseload managementpersonalized care plansclinical symptom monitoringtreatment options education