Clinical - Exception Template

Projected HM Candidate Review Date: 2 business days Number and Type of Interviews: Teams - 1 on video (MUST be camera ready) Extra Interview Prep for Candidate: N/A Required Testing or Assessment (by Vendor): N/A Manager Communication Preferences & Next Steps Background Check Requirements (List DFPS or other specialty checks here). This role is interesting because it provides a unique opportunity for the staff member to help Medicaid members who maybe struggling with mental health and substance abuse issues to ensure timely follow up after acute needs to ensure member receives needed care and services to maintain a healthy life.

Senior Care Manager, Transition of Care - J01079 - Exception Template

EEO:

Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.

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Assesses, plans and implements all aspects of medical and supporting services across the continuum of care for post-discharge members, promoting quality, cost effective care. Completes pre-admission and post-discharge medication reconciliation. Works with the care management and coordination teams to identify complex care transition support services. "Position Purpose: Assesses, plans and implements all aspects of medical and supporting services across the continuum of care for post-discharge members, promoting quality, cost effective care. Completes pre-admission and post-discharge medication reconciliation. Works with the care management and coordination teams to identify complex care transition support services. Education/Experience: Requires a Master's degree in Behavioral Health or Social Work and 4 6 years of related experience. License/Certification: LISW, LCSW, LMSW, LMFT, LMHC, LPC, or RN required" "Evaluates the needs of the member by completing clinical post-discharge assessments for members transitioning from healthcare facilities Evaluates medication and performs reconciliation between pre-admit and post-discharge medications Develops a care/service plan and collaborates with discharge planners, providers, specialists, and interdisciplinary teams to support member transition and discharge needs Assesses member current health status, resource needs, services, and treatment plans and provides appropriate interventions Facilitates transition into care management service for member based on acuity level Provides or facilitates education and resource materials to members, authorized caregivers, and providers to promote wellness activities to improve overall member quality of care Facilitates services between Primary Care Physician (PCP), specialists, medical providers, and non-medical resources as necessary to meet the medical and socio-economic needs of members May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources Serves as a subject matter expert to staff for clinical and non-clinical questions or issues related to post hospital outreach for members May precept new hires and support building core skills and providing guidance through the onboarding process Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators Provides feedback to leadership on opportunities to improve and enhance care and quality of delivery for members in a cost-effective manner Performs other duties as assigned Complies with all policies and standards"
Story Behind the Need Business Group & Key Projects
Health plan or business unit Team culture Surrounding team & key projects Purpose of this team Reason for the request Motivators for this need Any additional upcoming hiring needs?		Nebraska Total Care has a great team culture that supports staff to achieve daily goals and ensure members are connected to Medicaid services. The purpose of this role to ensure member receives adequate follow-up support following acute care visits. Need additional staff member to assist the team with outreach on evenings and weekends. If role successful potential to extend.
Typical Day in the Role
Daily schedule & OT expectations Typical task breakdown and rhythm Interaction level with team Work environment description		Looking for member outreach from 3-8 pm 5 days a week and 8 hour weekend days. Open to flexibility of time on weekends depending on best times to reach members and facilitate follow up. Staff would coordinate with local CM TOCs virtually. Member outreach will be via phone.
Compelling Story & Candidate Value Proposition
What makes this role interesting? Points about team culture Competitive market comparison Unique selling points Value added or experience gained		This role is interesting because it provides a unique opportunity for the staff member to help Medicaid members who maybe struggling with mental health and substance abuse issues to ensure timely follow up after acute needs to ensure member receives needed care and services to maintain a healthy life. The team at Nebraska Total Care is small and mighty which enables the team to communicate and function at a higher level.
Candidate Requirements
Education/Certification	Required: Masters Degree in Behavioral Health Field or Clinical Social Work			Preferred:
Licensure	Required: LMHP, LCSW, LISW, LMSW, LMFT, LMHC			Preferred:
Years of experience required- 2 years Disqualifiers- don t hold a NE License Best vs. average Performance indicators		Must haves: Empathy, strong communication skills, Critical thinking and ability to problem solve, ability to make decisions independently, self-starter & self-disciplined. Nice to haves: Substance use experience Disqualifiers: Don t have a NE License Performance indicators: We look at number of completed assessments to monitor performance Best vs. average:
Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection		1	Strong Communication Skills
		2	Knowledge of available behavioral health resources
		3	Ability to manage multiple technology systems
Candidate Review & Selection
Shortlisting process Second touchpoint for feedback Interview Information Onboard Process and Expectations		Projected HM Candidate Review Date:			2 business days
		Number and Type of Interviews:			Teams - 1 on video (MUST be camera ready)
		Extra Interview Prep for Candidate:			N/A
		Required Testing or Assessment (by Vendor):			N/A
Manager Communication Preferences & Next Steps
Background Check Requirements (List DFPS or other specialty checks here)		N/A
Do you have any upcoming PTO?		Aug 5-6
Colleagues to cc/delegate		Kristi (HL) reports to Paula Stapleton