Behavioral Health Care Manager

Intermountain Health • SelectHealth - Murray, GA

7d • $39 - $60 • Onsite

About The Position

Select Health is a community health plan serving more than 1 million members. Select Health’s lines of business include Medicare, Medicaid, FEHB, Marketplace Qualified Health Plans, and fully funded and self-funded Commercial plans. The Behavioral Health Care Manager works with Select Health members, their family, and a multi-disciplinary care team in a collaborative process of assessment, planning, facilitation, navigation, coordination, evaluation and advocacy In order for member to access benefits, resources, and services to meet comprehensive medical, behavioral, and social needs of members and their families while promoting self-management, quality, and cost-effective outcomes.
The Behavioral Health care manager works collaboratively with physicians and other members of the health care team to improve the health of patients with chronic conditions or complex needs. The position educates patients and caregivers to help them manage their health care needs. The incumbent facilitates communication, coordinates service, addresses barriers, and promotes optimal allocation of resources while balancing clinical quality and cost management. This position is responsible for assessing complex mental health needs, developing, documenting and implementing care plans, which will provide the appropriate resources to address social, physical, mental, emotional, spiritual, and supportive needs. Identifies members unable to adhere to a medical plan or members that require complex additional assistance and enrolls and follows these members in longitudinal care management services. Follows the applicable established model of care or care management program policies and procedures to assess, establish and maintain a plan of care which incorporates the member's individualized needs and goals within the benefit plan throughout the care management process. Ensures the plan is evidence based and consistent with goals and objectives of referral, payer contract, or established care processes. Maintains records by reviewing case notes, logging events and progress according to applicable regulatory requirements such as NCQA, CMS and State EQRO standards. Coordinates and facilitates communication with appropriate behavioral health specialists, facilities, the member/family/representative, members of the healthcare team, and other relevant parties (e.g., other payers, Sales Team, Employer Groups, etc.) through interdisciplinary team meetings or other coordinated communication. Contacts patient at prescribed intervals and as necessary to determine if the goals are being achieved or if they continue to be appropriate and/or realistic. Determines variances and refers patients to a more comprehensive level of care if indicated. Ability to assess, consult. refer and/or deescalate mental health crisis remotely and in real time.

Requirements

• CSW or equivalent master’s degree in behavioral health or psychology field.
• Valid State Licensure required in Utah with flexibility to obtain license in states included in Select Health Region.
• Demonstrated experience in care management/navigation or closely related field including Utilization Management, discharge planning, managed care, health promotion, health coaching, behavioral health, quality, or patient educator job role.
• Strong written and verbal communication skills.
• Demonstrated excellent written and verbal and conflict resolution communication skills.
• Intermediate computer software and hardware skills, ability to customize computer settings and use multiple monitors and capable of independent troubleshooting internet and applications.
• CSW hired or promoted into this role need to have or obtain their LCSW within one years of hire or promotion.

Nice To Haves

• LCSW
• Three years of experience and expertise working in clinical practice in an ambulatory care setting, community health or home care.
• Experience working with third party payers.
• Ability to work independently and be flexible in a rapidly changing environment.
• Experience working successfully in a remote environment or using Advanced Microsoft Suite, including Teams (chat, whiteboard, task tracking) & Outlook;
• Ability to work independently, be self-motivated, have a positive attitude, and be flexible in a rapidly changing environment.
• Minimum 1-year experience in care management/navigation or closely related field including Utilization Management, discharge planning, managed care, health promotion, health coaching, behavioral health, quality, or patient educator job role.

Responsibilities

• Assess, plan, facilitate, navigate, coordinate, evaluate, and advocate for members to access benefits, resources, and services.
• Meet comprehensive medical, behavioral, and social needs of members and their families.
• Promote self-management, quality, and cost-effective outcomes.
• Collaborate with physicians and the healthcare team to improve the health of patients with chronic conditions or complex needs.
• Educate patients and caregivers on managing their health care needs.
• Facilitate communication, coordinate services, address barriers, and promote optimal resource allocation.
• Balance clinical quality and cost management.
• Assess complex mental health needs, develop, document, and implement care plans.
• Provide appropriate resources to address social, physical, mental, emotional, spiritual, and supportive needs.
• Identify members unable to adhere to a medical plan or requiring complex additional assistance and enroll them in longitudinal care management services.
• Follow established models of care and program policies to assess, establish, and maintain a plan of care.
• Ensure the plan of care is evidence-based and consistent with referral goals, payer contracts, or established care processes.
• Maintain records by reviewing case notes, logging events and progress according to regulatory requirements (NCQA, CMS, State EQRO).
• Coordinate and facilitate communication with behavioral health specialists, facilities, members/families/representatives, healthcare team members, and other relevant parties.
• Contact patients at prescribed intervals to determine if goals are being achieved or remain appropriate/realistic.
• Determine variances and refer patients to a more comprehensive level of care if indicated.
• Assess, consult, refer, and/or deescalate mental health crises remotely and in real time.

Benefits

• Benefits Eligible: Yes
• Generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level