Posted Under: Baltimore, Maryland jobs in Executive; Executive jobs in zipcode 21276
Posted On: 2019-03-16
Qualification: Three to five years prior experience in behavioral health/human services required; or other equivalent background and experience that would translate well to this position. Bachelor's Degree in Social Work, Nursing or Human Services. The degree must be from an institution that is fully accredited by a nationally recognized educational accreditation organization and the individual must have completed a supervised field experience in case management, health or behavioral health as part of the degree requirements. Current Certification in Case Management (CCM) or eligible to take exam within 24 months of date of hire Must hold a valid, unrestricted State license in a behavioral health specialty or nursing. Acceptable licenses include but are not limited to LBSW, LMSW, RN, LPC Customer Service and previous telephone experience preferred, Previous experience in an office setting and/or doctor's office/ hospital preferred, Knowledge of human services system preferred The primary purpose of the job is to: The Care Manager is responsible for acting as a liaison between the behavioral health department and providers / members to provide care coordination and Care management services. The Care Manager will be responsible for outreach activity with members and providers. The Care Managers will document all activity in the member's medical record in the electronic Care management documentation system. . The Care Manager will collaborate with the Clinical Care Managers and the Medical Care Management team in identifying, reviewing and assessing members' need for behavioral health Care management. The Care Manager will assist in providing Care management services for members who have been enrolled in the program. The Care Manager will screen and facilitate the review outpatient treatment requests within contractual time frames. The Care Manager will process behavioral health appeals. PRINCIPLE ACCOUNTABILITIES Provide telephonic and/or community based Care management services to Members enrolled in Client DC Care management with a primary diagnosis of mental health or substance abuse Complete Health Risk Assessments (HRAs) with members Conduct outreach calls and send outreach letters to Members Develop care plans (short-term/long-term goals and tasks) and keep them updated Outreach to coordinate with PCP and other community providers as needed. Identify problems/barriers for care coordination and appropriate Care management interventions to resolve Identify barriers to member participation in treatment and solutions to resolve Document all Care management activity in the electronic Care management documentation system. Attend Care management meetings Collaborate with the medical Care management team, during scheduled meetings and informally as needed Participate in ongoing education in regard to the practice of Care management or related skill areas Perform other related duties and projects as assigned.