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Company Contact Info

  • Santa Clara, CA 95050
  • TJ DeNeal
  • Phone: 3102589661
  • Phone:: (310) 590-1090

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Behavioral Health Case Manager

Alls Well Health Care Services • Santa Clara, CA

Posted 2 months ago

Job Snapshot

Degree - None
Other Great Industries

Job Description

Under the direction of the Behavioral Health Program Manager, this position is responsible for clinical coordination and case management of SCFHP?s members requiring behavioral health services (BH), including substance use disorder (SUD) and Applied Behavioral Analysis (ABA) services. The primary purpose is the performance of work requiring advanced knowledge in a field of science or learning customarily acquired by a prolonged course of specialized intellectual instruction in the field of behavioral health care. The work is predominantly intellectual in character and requires consistent exercise of discretion and clinical decision making. MAJOR DUTIES AND RESPONSIBILITIES: Receive referrals from the Utilization Management and Medical Management Departments as well as the community for both Cal Medi-Connect and Medi-Cal members. Provide outreach to members and providers to coordinate care in order to ensure that appropriate and timely care is available to members. Ensure that BH, SU and ABA services are provided in accordance with regulations through coordination with SCFHP members, the County Mental Health Department (CMHD), Federally Qualified Health Care (FQHC) clinics and/ or community-based organizations. Ensure that assigned patients are provided Behavioral Health services and necessary medical attention at all locations. Provide consultation within the scope of licensure to SCFHP staff, as requested. Assists with locating and authorizing ABA and other Developmental services for members with autism spectrum disorder (ASD). Review State and Federal mandated benefits to ensure SCFHP?s BH program is in compliance. Participate in care plan reviews and interdisciplinary team conferences to ensure coordinated care for members according to the Coordinated Care Initiative (CCI). Review BH cases from the need for Long Term Support Services (LTSS) and provide appropriate referrals. Coordinate services between behavioral health providers, institutions, medical case managers and interdisciplinary teams on complex care coordination issues. Represent SCFHP in interactions with community behavioral health stakeholders involving clinical issues as directed by BH Program Manager. Facilitate interaction with behavioral health professionals within network, including County Mental Health and Drug and Alcohol Services (DADS). Represent SCFHP as assigned at integrated behavioral health collaborative meetings. Provide input on SCFHP initiatives that include a behavioral health component. Performs other duties, projects or functions as assigned. REQUIREMENTS: (E = Essential D = Desired) California Licensed Clinical Social Worker, Marriage and Family Therapist or Psychologist with a minimum of five (5) years of experience in clinical practice. (E) Experience with the safety net population preferred. (D) Experienced in Managed Care, Medicaid and/or Medicare strongly preferred. (D) Knowledge of principles of Managed Care. (E) Knowledge of pediatric behavioral health issues including Autism Spectrum Disorder. (E) Advanced skills with computer programs including MS Excel, Word, PowerPoint and Outlook. (E) Ability to work in a fast-paced environment and maintain courtesy and composure when dealing with internal and external customers. (E) Ability to prioritize workload and work independently. (E) Ability to function effectively with frequent interruptions and direction from multiple team members. (E) Demonstrated effective professional verbal and written communication skills. Able to communicate effectively to groups and individuals. (E) Able to maintain confidentiality of sensitive information. (E) Possess a valid California Driver License, with access to a reliable automobile with auto liability insurance, or have the ability to provide alternate transportation if prohibited by a medically documented disability from obtaining a driver?s license. (E) Physical requirements needed to perform the essen We are an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, sex, sexual orientation, age (40 and over), gender identity, national origin, protected veteran status, disability or any other protected classification under federal and state law.
Job ID: 3355/Behavioral Heal.95992
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