Exception Template

Summary:

• Work Mode: Remote- NE - MUST have NE licensure
• Must be available in the evenings during the week (flexible hours between 2pm-8pm) and on weekends (flexible hours with start time no earlier than 9am)
• Approved for up to 40 hours. Would like at least 20 hours a week with opportunity to increase hours with fluctuation in need.
• CST timezone

Responsibilities:

• Assess, plan, and implement all aspects of medical and supporting services across the continuum of care for post-discharge members, promoting quality, cost-effective care.
• Complete pre-admission and post-discharge medication reconciliation.
• Work with the care management and coordination teams to identify complex care transition support services.
• Evaluate the needs of the member by completing clinical post-discharge assessments for members transitioning from healthcare facilities.
• Develop a care/service plan and collaborate with discharge planners, providers, specialists, and interdisciplinary teams to support member transition and discharge needs.
• Facilitate 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.
• Serve as a subject matter expert to staff for clinical and non-clinical questions or issues related to post-hospital outreach for members.
• Precept new hires and support building core skills and providing guidance through the onboarding process.
• Collect, document, and maintain all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
• Provide feedback to leadership on opportunities to improve and enhance care and quality of delivery for members in a cost-effective manner.
• Perform other duties as assigned.

Requirements:

• Master's degree in Behavioral Health or Social Work.
• Minimum 4 years of related experience.
• Licensure: LISW, LCSW, LMSW, LMFT, LMHC, LPC, or RN required.
• Must have a NE License.
• Empathy, strong communication skills, critical thinking, and ability to problem solve.
• Ability to make decisions independently, self-starter & self-disciplined.

Preferred Skills:

• Substance use experience.
• Knowledge of available behavioral health resources.
• Ability to manage multiple technology systems.