Senior Business Manager – Complaints Strategy & Insights
Capital One
Behavioral Health Case Manager
Independent Health
full-time
Posted on:
Location: New York • 🇺🇸 United States
Visit company websiteSalary
💰 $34 - $38 per hour
Job Level
JuniorMid-Level
About the role
- The Behavioral Health Case Manager is primarily responsible for managing behavioral health benefits through the administration of quality improvement functions
- Develop a plan of care for identified population along the continuum of care within the scope of case management and accreditation standards
- Screen and assess member needs; develop person-centered care plans with goals
- Monitor and evaluate care plan effectiveness and modify as needed
- Coordinate with internal and external resources; collaborate with providers and community agencies
- Assist with hospital/facility discharge planning to coordinate post-inpatient BH treatment continuity
- Collaborate with Medical UM, Medical Case Management, and SIU for BH case reviews, product/benefit development, claims, and network activities
- Review policies, SOPs, reports and data related to BH CM programs
- Assist with annual program evaluations and work plans for BH CM programs
- Support quality improvement activities through data collection, measurement, reporting, evaluation and evidence-based intervention development for BH benefits and BH providers
- Participate in identification, analysis and evaluation of CM program outcomes; recommend interventions and implement improvements
- Attend meetings; establish professional relationships with Independent Health Associates
Requirements
- LMSW/ MSW/ LMHC/ LPC/ LMFT or RN in NYS required
- CCM certification required (must obtain within 2 years if not certified)
- 2 years of experience in behavioral health clinical/care coordination required
- Experience in health plan/managed care setting, case management and/or quality improvement preferred
- Experience in health coaching and motivational interviewing techniques preferred
- Excellent knowledge base of community resources and roles of various community agencies
- Proficient in MS Excel/Access; data collection, analysis and outcome measurements
- Excellent interpersonal, written, and verbal communication skills
- Proficient computer and Windows skills; MS Office
- Self-motivated, flexible, creative with problem-solving
- Ability to work flexible hours/overtime
- Demonstrated IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative, Accountable
