Outpatient Behavioral Health Case Manager

Geisinger•Scranton, PA

8d•Onsite

About The Position

Full Time; Day 8am - 4:30pm; Monday - Friday; REQUIRES: Master's Degree in Social Work AND Active PA Social Worker licensure (LSW) or ability to obtain LSW within 12 months of hire; Active PA Licensed Clinical Social Worker (LCSW) preferred...this is a great opportunity to support patients through resources and care coordination. Serves in an expanded clinical role to collaborate with patients, Primary Care Providers, community agencies, behavioral health, and other health plan departments to provide a model of care to maximize member’s health status. Integrates evidence-based clinical guidelines, preventive guidelines, protocols, and other metrics in the development of treatment plans that are patient-centric, promoting quality and efficiency in the delivery of healthcare for the Medicaid, Medicare and Commercial populations. Completes structured clinical assessments for identified patients. This requires knowledge of medical terminology, diagnostic criteria, and chart review. Designs an individualized plan of care with the member and fosters a team approach by working collaboratively with the member, family, primary care provider, and other members of the health care team to ensure coordination of services. Works closely with assigned primary care provider site and functions as a case manager for patients with behavioral health co-morbidities across the care team to develop and maintain positive working relationships with patients, families and providers. Implements clinical interventions based on risk stratification and evidence-based clinical guidelines in conjunction with the primary care provider or specialist. Contacts patients through written correspondence and telephone calls, and conducts follow-up interviews. Provides clinical oversight and guidance to team members. Participates in data collection, health outcomes reporting, clinical audits and programmatic evaluation related to government initiatives. In partnership with the care team, identifies patients at risk for poor outcomes or experiencing poor coordination of services who would benefit from more intensive follow up. Provides chronic disease and self-management education and support. Conducts in-home member assessments for high risk and complex patient cases. Develops collaborative relationships with community based agencies to improve care, services and access for Health Plan membership. Evaluates practices of self and colleagues against standards of practice and relevant regulations and acts to improve compliance. Maintains required documentation for all case management activities. Collects required data and utilizes this data to adjust the treatment plan when indicated. Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.

Requirements

Master's Degree in Social Work
Active PA Social Worker licensure (LSW) or ability to obtain LSW within 12 months of hire
Minimum of 2 years-Clinical
Computer Literacy
Critical Thinking
Organizing

Nice To Haves

Active PA Licensed Clinical Social Worker (LCSW) preferred

Responsibilities

Serves in an expanded clinical role to collaborate with patients, Primary Care Providers, community agencies, behavioral health, and other health plan departments to provide a model of care to maximize member’s health status.
Integrates evidence-based clinical guidelines, preventive guidelines, protocols, and other metrics in the development of treatment plans that are patient-centric, promoting quality and efficiency in the delivery of healthcare for the Medicaid, Medicare and Commercial populations.
Completes structured clinical assessments for identified patients.
Designs an individualized plan of care with the member and fosters a team approach by working collaboratively with the member, family, primary care provider, and other members of the health care team to ensure coordination of services.
Works closely with assigned primary care provider site and functions as a case manager for patients with behavioral health co-morbidities across the care team to develop and maintain positive working relationships with patients, families and providers.
Implements clinical interventions based on risk stratification and evidence-based clinical guidelines in conjunction with the primary care provider or specialist.
Contacts patients through written correspondence and telephone calls, and conducts follow-up interviews.
Provides clinical oversight and guidance to team members.
Participates in data collection, health outcomes reporting, clinical audits and programmatic evaluation related to government initiatives.
In partnership with the care team, identifies patients at risk for poor outcomes or experiencing poor coordination of services who would benefit from more intensive follow up.
Provides chronic disease and self-management education and support.
Conducts in-home member assessments for high risk and complex patient cases.
Develops collaborative relationships with community based agencies to improve care, services and access for Health Plan membership.
Evaluates practices of self and colleagues against standards of practice and relevant regulations and acts to improve compliance.
Maintains required documentation for all case management activities.
Collects required data and utilizes this data to adjust the treatment plan when indicated.

Benefits

Full benefits (health, dental and vision) starting on day one
Three medical plan choices, including an expanded network for out-of-area employees and dependents
Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) and a health savings account (HSA) with employer contribution
Company-paid life insurance, short-term disability, and long-term disability coverage
401(k) plan that includes automatic Geisinger contribution
Generous paid time off (PTO) plan that allows you to accrue time quickly
Up to $5,000 in tuition reimbursement per calendar year
MyHealth Rewards wellness program to improve your health while earning a financial incentive
Family-friendly support including adoption and fertility assistance, parental leave pay, military leave pay and a free Care.com membership with discounted backup care for your loved ones
Employee Assistance Program (EAP): Referrals for childcare, eldercare, & pet care. Access free legal guidance, mental health visits, work-life support, digital self-help tools and more
Voluntary benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life and pet and legal insurance
healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners