Clinical Care Management Specialist

Community Behavioral Health. • Philadelphia, PA

32d • Onsite

About The Position

The Clinical Care Management Specialist/Integrated Care Specialist provides clinical recommendations and collaborative support to team members and physical health care staff involved in the Integrated Care Plan (ICP) Program.

The Clinical Care Management Specialist reviews clinical information using a holistic care framework, makes recommendations for appropriate levels of care, creates Integrated Care Plans and coordinates services for individuals referred to the ICP team.

Requirements

• Education: Master’s degree in Social Work or related field
• Clinical Licensure: Qualified candidates are required to obtain license within the first 18 months (1.5 years) of employment; PA Child Abuse Clearance required
• Required Licensure: Licensed Social Worker (LSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW)
• Relevant Work Experience: Minimum of 3 years of direct clinical care experience working with adults in behavioral health or physical health settings; experience in assessment and treatment planning and/or experience in a managed care setting. Must possess knowledge of evidence-based treatment for behavioral health challenges to make appropriate referrals for care.
• Skills: Ability to work collaboratively with cross-system partners
• Excellent verbal and written communication skills and ability to interact with broad range of individuals
• Strong mediation skills
• Computer proficiency and ability to type at least 20 words per minute
• Ability to work independently in fast-paced environment
• Compliant with HIPAA regulations
• The successful candidate must be a current Philadelphia resident or become a resident within six months of hire.

Responsibilities

• CCMS will travel amongst the identified community partnership sites and participate in case information sharing as scheduled.
• CCMS will develop a schedule with each practice site, PH MCO and CBH team staff for onsite visits to consent members for participation in the Integrated Care Plan Program, share released information with the PH MCO and discuss case recommendations with the appropriate internal staff.
• CCMS will complete Integrated Care Plans as outlined by the policies and regulations of CBH and the state.
• CCMS will create Integrated Care Plans for members referred from community partners, internal referrals for ICP development and for members who meet appropriate criteria for ICP planning.
• During the case collaborations with sites and PH MCO’s, CCMS will provide behavioral health treatment utilization and develop care plans tailored to the individual’s current needs as part of the treatment team.
• CCMS will coordinate with internal CBH staff to ensure communication and collaboration is clear and the individual’s developed care plan is carried out as such.
• CCMS will participate in the problem solving process and provide information on additional community resources as needed.
• CCMS will do utilization review as necessary for assigned members, implementing medical necessity criteria to inform level of care determinations.
• CCMS will document and track their interventions and share data internally and with associated partner’s, like PH MCO’s and community partnership sites.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 251-500 employees