To begin the application process, please enter your email address.
Company Contact Info
- Chehalis, WA
Sorry, we cannot save or unsave this job right now.
Report this Job
Email Send Failed!
Mental Health Care Manager
Great Rivers Behavioral Health Organization • Chehalis, WA
Posted 25 days ago
Get facts about other applicants with a CareerBuilder Account
Are you looking for an organization that is considered to be one of the fastest growing industries in the US? Great Rivers BHO is excited to announce the Care Management (CM) Coordinator position where you will have the ability to join a dynamic team as we model the way towards integrated healthcare. All Team Members are eligible for competitive benefits, while working for an organization that promotes learning and development opportunities, flexible scheduling, and a supportive work/life balance.
The Care Management (CM) Coordinator oversees care for high-risk individuals of all ages with mental health and/or substance use disorders (SUD). This positon focuses on facilitating access to care, collecting information to support appropriate referrals and coordinating care for consumers and members experiencing high risk situations. The CM Coordinator ensures that care provided aligns with Great Rivers’ values and goals, regulations, medical necessity guidelines, and utilization standards. This position works closely with Great Rivers Utilization Coordinators to ensure that all necessary documentation is generated and maintained in an appropriate manner.
Effective April 1, 2016, Great Rivers Behavioral Health Organization is the fiscal agent for publicly-funded mental health and substance use disorder treatment in Cowlitz, Grays Harbor, Lewis, Pacific, and Wahkiakum counties. Our mission is to provide access to high quality comprehensive systems of care that yield the outcomes desired by people with mental health and/or substance use conditions.
Summary of the Essential Duties and Responsibilities
- Actively manages care for all high-risk members, including individuals with mental health and/or substance use disorders (SUD). Track and monitor clinical cases. Actively coordinate care with providers to ensure that individuals are receiving services that are medically necessary, and document the coordination of care clearly.
- Participates in treatment/service planning for high risk members. Completes telephone assessments and emergency, urgent, and routine referrals; gathers clinical information to connect members with appropriate providers, including outpatient treatment, as necessary. Provides clinical consultation on mental health and/or substance use treatment to network providers under the supervision of the Chief Clinical Officer and UM/CM Manager, responds to questions from the community and providers regarding mental health services for priority/high risk and utilization populations.
- Receives individual case referrals from Great Rivers Utilization Management Team, and reviews the cases for clinical appropriateness of authorization requests, including review of treatment plans, assessments, and other documentation. Collaborates on authorization decisions with Utilization Managers and Authorization Coordinators.
- Utilizes clinical rounds and prepare case presentations to staff individuals with Medical Director, Chief Clinical Officer, and UM/CM Manager for individuals that do not meet medical necessity criteria or individuals who are not benefiting from current treatment or have complex conditions.
- Communicates with Quality Management and Provider Network Management staff regularly to report on provider quality of care, contract compliance, and compliments and grievances. Consults with Great Rivers’ network operations to share provider information on responsiveness during the care management process.
- Maintains effective working relationships with providers and community stakeholders. Provides outreach to potential Medicaid populations informing them on how to access Medicaid services and become enrolled in Medicaid.
- Provides regular reporting and presentations that includes integrating information from multiple sources, provides technical support to various groups as assigned, and provides information for advisory boards and elected officials.
- Performs other duties and projects as assigned by the supervisor.
Additional Duties and Responsibilities as Mental Health Professional (MHP) CM Coordinator:
- Offers clinical opinions related to level of care, duration, and intensity of care utilizing professional knowledge to apply DSM-V, Access to Care standards, and other Great Rivers medical necessity criteria and render authorization decisions.
- Provides technical assistance to contracted providers on mental health Access to Care standards to determine medical necessity and utilization standards by responding to requests and needs.
- A master’s degree in a clinical field that meets Washington State’s Mental Health Professional criteria.
- Two (2) years of clinical experience such as direct care, care coordination or case management in either public or private healthcare operations serving adults and/or youth.
- Proficient in computer use and applications commonly used or applied in this field/trade/position such as Microsoft Office software and capacity to learn use of care management software.
- Possess and maintain a valid driver’s license. Pass and maintain a clear background record as required by contractual requirements for healthcare organization under state and federal contracts.
- Washington State Certification as a Chemical Dependency Professional.
- Washington Department of Health licensure or associate license in Mental Health to include LMHC/A, LMFT/A, LICSW/A.