Manager

• Run SUD TOC Groups (Substance Use Disorder Transition of Care) three times a week at Worcester Area detoxes
• Support Members discharging from detox accessing treatment
• Complete Utilization Management for inpatient and outpatient level of care
• Perform case management telephonically and/or by home visits within the scope of licensure for members with behavioral health and substance abuse or substance abuse disorder needs
• Respond to more complex cases and account specific requests
• Use appropriate screening criteria knowledge and clinical judgment to assess member needs
• Conduct assessments to identify individual needs and develop specific care plan to address objectives and goals
• Monitor and evaluate effectiveness of care plan and modify plan as needed
• Support member access to appropriate quality and cost-effective care
• Coordinate with internal and external resources to meet identified needs of the members and collaborate with providers
• Serve as a resource to other BH Case Managers
• Participate in cross-functional teams, projects and initiatives
• Required to go to Worcester, MA and surrounding areas detox centers to run group meetings 3 or more days a week

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