Establish and continuously model supportive and collaborative relationships with members, colleagues, and external partners.
Model the highest ethical behavior in care for Members, as well as in relationships with co-workers, Leaders, internal, and external partners.
Model commitment to continuous quality improvement by engaging in quality improvement initiatives and projects, such as by identifying and addressing HEDIS gaps, and by identifying, developing, and testing new practices for improving the outcomes of the Enhanced Care Management team.
Participates in Health Plan staff meetings, trainings, committee meetings, or other activities as needed or as directed by Leadership Team Members.
Working in a lead training capacity by providing formal and informal clinical training and other learning and development activities to support department Team Members on behavioral health conditions, including treatments and evidence-base for treatment (within areas of expertise/scope) as well as provide onboarding and ongoing training to department Team Members.
Promote a collaborative and effective working environment within the department or those outside BH discipline by engaging in evidenced-based communication strategies (such as Motivational Interviewing) when discussing responsibility/sharing of tasks, effectively resolving conflicts as they arise, and collaborating on Member case discussions to provide integrated care to IEHP members.
Participate in committees, conferences, and any other meetings as required or directed by department managers or directors.
Responsible for primarily working with a caseload of Members with behavioral health needs.
Advocate for Members to receive the highest quality care, in a timely manner, within IEHP’s network by referring to appropriate internal partners such as behavioral health, Enhanced Care Management, and complex care management.
In conjunction with department leadership, the Licensed Behavioral Health Care Manager is responsible for providing consultation for the non-licensed Members of the team when discussing tasks of a clinical nature.
Responsible for engaging with Members to provide effective care management, both in-person and on the phone, including linkage to resources and support in transitions of care, in a manner that utilizes evidence-based approaches (such as Motivational Interviewing) that promotes collaboration between the Member and his or her medical/behavioral team, facilitating member self-efficacy and self-management to improve the Member’s ability to manage their own health, and all other activities associated with high quality, evidenced-based care management.
Ensures documentation is accurate and in compliance with regulatory requirements and accreditation standards.
Assist Members with care coordination needs, including, but not limited to the following: Conduct comprehensive, holistic assessment both telephonically as well as in person (facility or home visits). Assimilate assessment information to assist, in collaboration with the ITC Team and the facility, in developing a discharge plan or an individualized care plan (ICP). Communicate ICP or discharge plan with Member, approved family or caregiver and other Members of the care team.
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Requirements
Minimum of three (3) years of experience performing or facilitating Behavioral Health/Medical Social Work services
Experience in motivational interviewing and/or other evidenced-based communication strategies
Experience working successfully within a team, and experience in developing and maintaining effective relationships with both clients and coworkers is mandatory
Master’s degree in Social Work or related field from an accredited institution required
Possession of an active, unrestricted, and unencumbered license in a Social Services related field issued by the California Board of Behavioral Sciences required (LCSW or LMFT preferred)
Key Qualifications Must have a valid California Driver's License
Behavioral Health/Medical Social Work services experience in a health clinic psychiatric hospital, medical facility, or health care clinic strongly preferred
Experience in clinical services, both mental health and substance use preferred
Familiarity with providing Behavioral Health Care and discharge planning is required
Knowledgeable and skilled in evidenced-based communication such as Motivational Interviewing, or similar empathy-based communication strategies
Understanding of and sensitivity to multi-cultural communities
Deep understanding and knowledge of mental health and substance use conditions, including both acute and chronic management
Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both
Must have knowledge of whole health and integrated principles and practices
Bilingual (English/IEHP Threshold Language) – written and verbal is highly preferred
Highly skilled in interpersonal communication, including conflict resolution
Effective written and oral communication skills, as well as reasoning and problem-solving skills
Skillful in informally and formally sharing expertise.
Must have the resiliency to tolerate and adapt to a moderate level of change and development around new models of care and care management practices
Proficient in the use of computer software including, but not limited to, Microsoft Word, Excel, PowerPoint
Demonstrated proficiency with all electronic medical management systems (e.g., Cisco, MHK/Care Prominence, MediTrac, SuperSearch and Web Portal) is preferred
Proven ability to:
Sufficiently engage Members and providers on the phone as well as in person
Work as a member of a team, executing job duties and making skillful decisions within one’s scope
Establish and maintain a constructive relationship with diverse Members, Leadership, Team Members, external partners, and vendors
Prioritize multiple tasks as well as identify and resolve problems
Have effective time management and the ability to work in a fast-paced environment
Be extremely organized with attention to detail and accuracy of work product
Have timely turnaround of assignments
To form cross-functional and interdepartmental relationships
Start your journey towards a thriving future with IEHP and apply TODAY !