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