Behavioral Health Case Manager

Blue Cross and Blue Shield of Louisiana

Baton Rouge, LA

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JOB DETAILS

SKILLS

Analysis Skills, Behavioral Health, Best Practices, Case Management, Certified Case Manager (CCM), Clinical Assessment, Communication Skills, Community Support, Crisis Intervention, Cross-Functional, Current Procedural Terminology (CPT), Emergency Services, Health Insurance, Health Plan, Healthcare, Healthcare Providers, Identify Issues, Insurance, Interpersonal Skills, Law Enforcement, Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Practical Nurse/Licensed Vocational Nurse, Maintain Compliance, Managed Care, Medical Record System, Medical Treatment, Medicare, Needs Assessment, Nursing, Outpatient Care, Patient Care, Pharmacy, Physical Demands, Policy Development, Primary Care, Procedure Development, Quality Assurance, Quality Management, Quality of Care, Registered Nurse (RN), Regulatory Compliance, Regulatory Requirements, Risk Analysis, Social Security Administration, Social Work, Telephone Skills, Time Management, Training/Teaching, Utilization Management

LOCATION

Baton Rouge, LA

POSTED

Today

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with us.

Residency in or relocation to Louisiana is preferred for all positions.

POSITION PURPOSE .

Telephonic or in-person, coordination and management of behavioral health services for members enrolled in both Medicare and Commercial insurance plans. This role involves comprehensive assessment, evaluation, care planning, service coordination, and ongoing monitoring to ensure members receive timely, appropriate, and effective behavioral health care. The Behavioral Health Case Manager will collaborate with internal teams, external providers, family members, and community resources to support members in optimizing care and improving health outcomes. Will also receive and resolve crisis calls from plan members and provide immediate crisis intervention, risk assessment, and coordination of emergency services as needed.

How You Contribute to the Company’s Mission In This Role

+ Conduct comprehensive behavioral health assessments to identify member needs, strengths, and goals.

+ Develop, implement, and monitor individualized care plans in collaboration with members, families, and providers.

+ Identify and coordinate behavioral health services across the continuum of care, including inpatient, outpatient, and community-based services.

+ Facilitate level of care transitions and ensure follow-up after hospitalizations or emergency interventions.

+ Provide education and support to members and families regarding behavioral health conditions, treatment options, and community resources.

+ Collaborate with Utilization Management, Customer/Member services, medical case managers, primary care providers, and behavioral health specialists to ensure integrated care.

+ Document all case management activities in compliance with regulatory and organizational standards.

+ Participate in interdisciplinary case rounds and quality improvement initiatives.

+ Actively participate in staffing the company’s 24/7/365 crisis call line, providing immediate crisis intervention, risk assessment, and coordination of emergency services as needed. Regularly participate in the schedule rotation to ensure staff availability to immediately answer crisis calls outside of normal business hours to include weekends and holidays.

+ Maintain up-to-date knowledge of behavioral health best practices, regulatory requirements, and community resources.

Required Qualifications

+ Bachelor’s degree in nursing, healthcare, or a related field OR master’s degree in social work, counseling, or behavioral health

+ RN license in Louisiana can replace Bachelor's degree OR LPN license in Louisiana + 2 years of related experience can replace the bachelor’s degree

+ Minimum of three years of experience in case management which includes behavioral health, behavioral health clinical practice, or behavioral health crisis intervention

+ LPC, LCSW, LMFT, RN, or LPN license required

+ Strong clinical assessment and critical thinking skills

+ Excellent communication and interpersonal abilities

+ Strong understanding of behavioral health diagnoses and treatment modalities

+ Proficiency in electronic health records and case management systems

+ Ability to work independently and as part of a multidisciplinary team

+ Ability to make decisions based on established policies and procedures

+ Comfortable working in a fast-paced, dynamic environment with rotating crisis line responsibilities

+ Case Management Certification preferred but must be attained within 3 years after date of hire

Preferred Qualifications

+ Experience working with Medicare and Commercial populations

+ Experience in a managed care or health insurance setting

+ Familiarity with CPT codes and billing practices.

+ Experience in crisis intervention and de-escalation techniques

_The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions_

+ Perform other job-related duties as assigned, within your scope of responsibilities.

+ Job duties are performed in a normal and clean office environment with normal noise levels.

+ Work is predominately done while standing or sitting.

+ The ability to comprehend, document, calculate, visualize, and analyze are required.

An Equal Opportunity Employer

All internal employees please apply through Workday Careers.

PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)

Additional Information

Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.

If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact recruiting@bcbsla.com for assistance.

In support of our mission to improve the health and lives of Louisianians, we encourage the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.

_We perform background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner._

_Additionally, we are a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results._

JOB CATEGORY:Healthcare/Pharmacy Services

Behavioral Health Case Manager

Blue Cross and Blue Shield of Louisiana

Baton Rouge, LA

About the Company

Blue Cross and Blue Shield of Louisiana

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