Case Manager I

Job Title: Case Manager I

Location: Remote + Field Visit (Albuquerque or Las Cruces)

Duration: 3 Months+ (Possible Extension)

Schedule: 8 Am – 5 Pm Mon - Fri (MST)

Job Description:

Is this a temp to hire position? It could be in the future but not right now.

Required Licensure / Education:

· The care management personnel must hold one of the licenses (or relevant state equivalent) below to participate in the initiative:

· Clinical Social Workers (ex. LCSW, LISCW)

· Professional Counsellors/Licensed Mental Health Counsellors (ex. LPC/LPCC, LMHC)

· Marriage and Family Therapists (LMFT)

· Certified Alcohol and Drug Counsellor (CADC)

· Substance Use Disorder Professional (SUDP)

· These staff should have unrestricted license in the state in which they are working as a care manager and a National Provider Identifier.

Required Years of Experience : 3 years

· The utilization of specific care management staff to conduct visits (telephonic or face-to-face to satisfy the requirements of multiple Behavioral health follow-up measures (FUH, FUM, FUI, and IET).

· Measures In Product:

· FUH - Follow up After Hospitalization for Mental Illness

· FUM - Follow up After Emergency Department Visit for Mental Illness

· FUI - Follow up After High Intensity Care for Substance Disorder

· IET-Initiation and Engagement of Alcohol and other Drug Abuse or Dependence Treatment

Must have skills:

·         Active, unrestricted Behavioral health clinical license in the state of practice (LCSW/LISW, LPC/LPCC/LMHC, LMFT, CADC, SUDP, or state equivalent) · National Provider Identifier (NPI) required

·         Minimum of 3 years of experience in Behavioral health, substance use disorder treatment, care management, or a related clinical setting

·         Demonstrated Behavioral health care management experience, including transitional support following hospitalizations or emergency department visits.

·         Strong working knowledge of Behavioral health quality and HEDIS measures, including FUH, FUM, FUI, and IE

·         Proven ability to conduct telephonic and/or face-to-face outreach with members to support follow-up care · Experience scheduling and coordinating appointments with Behavioral health providers or internal care teams. Ability to utilize established care management programs to provide ongoing member support

·         Excellent clinical documentation skills, with the ability to accurately document member interactions in accordance with job aides and compliance requirements.

·         Strong communication and collaboration skills, including the ability to work with leadership and interdisciplinary teams

·         Demonstrated ability to handle and protect PHI in compliance with healthcare privacy and security standards

Day to Day Responsibilities:

·         CM staff responsibilities include Reaching out to members identified for transitional support.

·         Scheduling appointments with members’ Behavioral health treatment providers or Care Connections.

·         Utilizing existing care management programs to provide ongoing member support.

·         Documenting all member interactions, ensuring compliance with the job aide to contribute to HEDIS goals.

·         Communicating with local leadership regarding any questions or concerns about the procedures.