Apply online at http://www.alohacare.org/Careers/Default.aspx
The Company:
AlohaCare is a local, non-profit health plan serving Hawai`i’s low-income residents with free Medicaid and dual Medicare health insurance coverage. Our members include children, seniors, and adults residing on all islands. We provide comprehensive benefits and managed care services with an emphasis on healthy living habits and preventive primary health care. Our approach is to meet the whole-person health and social needs of members. Through our community partnerships we offer innovative services such as connection to social service agencies, Native Hawaiian healing services and in-home primary care for qualified members. Our mission is to serve in the true spirit of aloha by ensuring and advocating for access to quality health care for all. We are Hawaii’s third-largest health plan and offer a wide network of quality primary care, specialists, hospitals, pharmacies and among many other providers across the state.
The Culture:
AlohaCare employees have a passion for helping Hawai`i’s most underserved communities. Our caring culture is fundamental to our company-wide team approach to providing high-quality services. We support our employees with a supportive and positive work environment, healthy work-life balance, continuous communication, and a generous benefits package.
AlohaCare’s leadership empowers and engages its employees by recognizing outstanding job performance and collaboration. We share organization-wide updates during quarterly All Staff meetings. We encourage participation in volunteer and educational opportunities. We put a high value on honesty, respect, and trust-building. We encourage open-door, two-way, and frequent communication.
AlohaCare’s comprehensive benefits package includes low-cost medical, dental, drug and vision insurance, paid time-off, 401k employer contribution, referral bonus and pretax transportation and parking program.
The Opportunity:
The Behavioral Health Inpatient Engager is responsible for completing a face-to-face engagement with members who are currently inpatient and/or recently discharged from the hospital. The Behavioral Health Inpatient Engager is also responsible for coordinating with hospital staff, community providers, and AlohaCare staff including Health Coordination, Care Navigators, Community Health Workers, Community Integrative Services (CIS) housing coordinators, Community Care Services (CCS) case managers and staff.
The Behavioral Health Inpatient Engager may also work in collaboration with clinical operations staff, primary care providers and specialists, community resources, the members, family members and/or caregivers. Job functions with requirements of Med-QUEST, QUEST Integration, Medicare contractual performance policies and procedures and NCQA standards.
Primary Duties & Responsibilities:
- Conduct in-person outreach and engagement with members admitted to psychiatric inpatient units, emergency departments, crisis stabilization units, and medical floors.
- Complete biopsychosocial assessments and identify clinical, environmental, and social determinants of health affecting recovery.
- Develop individualized transition and service plans based on member needs, strengths, and preferences.
- Collaborate with hospital staff, psychiatrists, physicians, nurses, social workers, and community providers to coordinate care.
- Collaborate with family members, caregivers, and natural supports when appropriate.
- Conduct telephonic, virtual, or face-to-face follow-up contacts to monitor stabilization and engagement in services.
- Facilitate seamless transitions from hospital settings to outpatient levels of care.
- Coordinate follow-up appointments prior to discharge whenever possible.
- Confirm linkage to community providers and supportive services.
- Address barriers that may impact successful discharge, including housing instability, transportation, medication access, and financial concerns.
- Collaborate with family members, caregivers, and natural supports when appropriate.
- Identify early warning signs of deterioration and coordinate interventions to prevent crisis escalation and rehospitalization.
- Coordinate referrals and linkage to behavioral health treatment providers, primary care providers, substance use treatment programs, peer support, housing resources, transportation services, and other community-based supports.
- If necessary, refer members to Health Coordination, Disease management, Care Navigators, Community Health Workers, CIS housing coordinators, and CCS staff when additional assistance is required.
- Maintains accurate and up to date written documentation and records of activities in information system (Guiding Care/G8) according to appropriate guidelines.
- Ensures compliance with all state and federal regulations, including HIPAA standards of confidentially protected health information, reporting of critical incidents, and reporting of quality-of-care issues.
- Participate in Behavioral Health staff meetings, interdisciplinary care team meetings, trainings, in-services, and discharge planning rounds.
- All other duties assigned.
- Adhere to regulatory compliance and quality guidelines as well as AlohaCare policies and procedures.
- Responsible for maintaining AlohaCare’s confidential information in accordance with AlohaCare policies, state and federal laws, and rules and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.
Requirements:
- Bachelor’s degree in Nursing, Social Work, Public Health, Behavioral Health, or related field or equivalent combination of education and experience.
- Minimum of 1 year of related work experience in a clinical setting and/or in a managed care environment, experience with behavioral health case management, health plan experience, or other related work experience.
- Experience with performing post-inpatient transition of care activities.
- Ability to network with other providers for successful transition from inpatient to community-based services.
- Prior experience in clinical assessments, discharge planning, and utilization management.
- Ability to work with varied teams/professionals for inter-disciplinary case consultation and discharge planning.
- Knowledge of local resources, providers, and referral processes.
- Support AlohaCare’ s corporate core values in all interactions.
- Achieves results, builds trust, communicate effectively, customer and quality focused.
- Strong interpersonal and facilitation skills with the ability to communicate with all levels of the organization.
- Strong, effective, and precise written and oral communication skills; speak clearly and persuasively in positive or negative situations.
- Professional telephonic etiquette skills.
- Ability to solve problems, analyze, think critically, and make good judgments.
- Strong customer service skills and be able to work in a diverse, demanding and evolving environment with strong conflict and problem resolution skills.
- Able to work independently with minimal supervision.
- Able to effectively work in a fast-paced and changing environment, manage multiple projects and priorities across multiple teams/projects and in a matrixed environment.
- Possesses excellent time management and organizational skills; dependable, enthusiastic, self-starting, and self-motivated. Uses time effectively, reacts professionally under pressure.
- Intermediate skills in Microsoft Programs: Word, Excel or Access Databases, Outlook and PowerPoint Experience in the operation of general office equipment to include PC, fax/copy machine and phone system.
- Possession and maintenance of a valid driver's license with access to a reliable automobile and acceptable driving record.
- TB Clearance
- First Aid and CPR Certification
Preferred Requirements:
- Licensed RN, LPN, LSW, LMHC, or LCSW in the State of Hawaii
- Experience with QUEST and Medicare programs and working knowledge of managed health care field.
- Experience with individuals who are low-income or have special health care needs, including: HIV/AIDS, developmental disabilities, medical -fragile, older adults, and individuals with physical disabilities.
- Knowledge of local resources, providers, and referral processes.
Mental, Physical and Environmental Demands:
Salary Range: $61,000 - $80,000 annually
AlohaCare is committed to providing equal employment opportunities to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record, disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veteran status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.