BH Clinical Care Manager

Commonwealth Clinical Alliance•Boston, MA

21h•Remote

About The Position

Commonwealth Care Alliance’s (CCA) Clinical Care Manager is a registered nurse or other independently licensed behavioral health clinician responsible for providing intensive monitoring, follow-up and clinical care management to a panel of health plan members with complex medical, behavioral, and social care needs, including Severe and Persistent Mental illness. As part of the care management dyad, the Clinical Care Manager works directly with assigned CCA members to help them navigate the health care system, gain access to available services, and assist members with finding answers to their questions. The Clinical Care Manager functions as the clinical expert on an interdisciplinary team through close member oversight, routine and post discharge assessments, providing health education, and provider collaboration. Consults, as needed, with other participants of the interdisciplinary care team on members experiencing medical or behavioral health issues. Responsible for supporting the members in achieving their goals for independent living, recovery, and community connections. This position allows for remote work, when possible, but does require in-person visits to members in their homes and community, as needed. Supervision Exercised: No, this position does not have direct reports.

Requirements

BH Clinical Care Managers must have: Master’s degree in social work or mental health counseling
Must have an active LCSW, LMHC or LICSW license in good standing in the state assigned; may require multiple state licenses based on product
Meaningful clinical and care management experience, including 3+ years caring for people with complex medical, behavioral and social needs
Proven skills, knowledge base, and judgement necessary for independent clinical decision making in alignment with clinical licensure.
Excellent critical thinking, organizational, time management and problem solving skills.
Ability to function independently and effectively as part of an interdisciplinary team
Strong and effective communication skills, both written and verbal
Strong interpersonal and customer relations skills
Strong customer service skills
Ability to work in multiple systems, often simultaneously.
Flexibility to adapt to business needs
Motivated team player
High attention to detail and accuracy
English

Nice To Haves

Bachelor’s or Master’s degree in nursing preferred
Other related Healthcare Degree
Certified Care Manager (CCM)
Experience working in a health plan, with Medicare Advantage and/or dually eligible population
Experience with a care management platform (Guiding Care a plus)
Experience with Substance Use Disorders
Ability to utilize an Electronic Medical Record or other electronic platforms
Ability to use on-line training platforms
Demonstrated ability to utilize virtual care platforms
Proficiency in Microsoft Office Suite
Bilingual preferred

Responsibilities

Complex care management
Care plan development, updates and implementation with members
Member education
Provider communication, including collaboration with DMH and DDS (BH)
Routine member engagement
Quality gap closures, including: RN Clinical Care Manager BH Clinical Care Manager Medication Reconciliation Follow up after Hospitalization (FUH) Blood Pressure readings Initiation and Engagement (IET)
Participate in interdisciplinary care team meetings
Performs applicable standardized assessments, including MDS, Comprehensive, Functional, and Crisis and Risk Assessments
Perform home visits with member for routine assessments, routine clinical needs, and post transitions of care follow up that require in person evaluations
Monitor available data for assigned members to inform proactive outreaches as well as reactive clinically appropriate assessments to ensure comprehensive knowledge of members current needs to inform continuous and meaningful updates to the care and service plan.
Resource and expert for members regarding available benefits and resources to meet their needs.
Clinical resource for other members of the interdisciplinary care team
Additional duties as requested by supervisor