At Vantage Health Plan, Inc., we specialize in taking care of people: our members, our patients, and our employees. We offer competitive salaries and great benefits! Benefits include: Health, Dental, Life, Accidental Death and Dismemberment, Long Term Disability, Paid Time Off, and 401(k).
Job Summary: The Behavioral Health Case Manager is responsible for assessing Medicare, Commercial, and Exchange members by evaluating behavioral health needs and requirements, collaborating with the member, care providers, and multi-disciplinary team to manage behavioral health and psycho-social health issues.
Essential Duties & Responsibilities:
•Proactive telephonic outreach to eligible Vantage Health Plan members and/or AHG clinic patients to engage participation in behavioral health care management programs offered by the Department
• Assess members with behavioral health issues to evaluate current health status, history of behavioral health treatment, resource needs, and compliance
• Actively participate in all enrollment activities
• Perform general case management and follow-up of members who have a need but do not meet criteria for the behavioral health care management programs
• Complete psychological, emotional and environmental assessments, for the purpose of providing appropriate, timely interventions to ensure provision of optimal care
• Work collaboratively with other members of the Vantage Cares Interdisciplinary team-to include: Vantage Case Managers, Social Services, Field Care Managers, Transitional Care, and the members’ Provider(s)
• Monitor member for compliance with medications and appointments
• Educate family and caregivers on behavioral health disease process
• Guide members and their families toward and facilitate interaction with resources appropriate for the care and well being of members
• Coordinate care with PCP, psychiatrist, therapist, home health provider, community resources, etc.
• Track member’s progress including frequency of hospitalizations and admissions to outpatient services
• Understand clinical program design, implementation, documentation and reporting
• Provide behavioral screening and intervention services at Affinity clinics as needed and assist with psychiatric crisis triage as appropriate
• Comply with performance and reporting standards as defined by Vantage Health Plan
• Additional responsibilities as deemed appropriate by Health Management leadership
•Assists the Integrated Care Management team as needed with other duties in the role and is flexible to new ideas
• Able to adapt and or adopt quality improvement policies and procedures for the department.
• Actively serves on the Case Management Team and attends Case Management Team meetings
• Able to work in several computer program systems, and documents electronically.
• Able to work independently and interdepartmentally to obtain departmental and organizational goals
• Other duties as assigned
Knowledge, Skills, and Abilities:
• Degree in Social Work, Counseling, Psychology or Nursing from an accredited degree program (preferred) or minimum of five years of experience in behavioral health case management
• Minimum of 3 years of experience in clinical setting required
• Experience in crisis intervention and treatment of behavioral health disorders and/or substance abuse
• Knowledge of community resources
• Strong problem solving and analytical skills
• Ability to use Microsoft Office Suite (Excel, Word, Power Point, etc.)
• Highly organized and efficient with strong attention to detail
• Excellent verbal and written communication skills
• Ability to work under limited supervision and make sound decisions based on established policies and procedures
• Ability to interact effectively with all levels of staff
• This position has no supervisory responsibilities
• Works under general supervision of the Manager of Integrated Care
• This position operates in a professional office/clinic environment
• This is a full-time position (40 hours/week)
• Overtime may be required
• Some travel required
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable qualified individuals with disabilities to satisfactorily perform these essential functions without causing an undue hardship for the employer.
While performing the duties of this job, the employee is required to remain in a stationary position for long periods of time and must frequently move about the office. The employee must constantly operate a computer and other office equipment such as phones, keyboards, printers, and copiers. The employee is regularly required to communicate with others via phone, email, etc. Occasionally, the employee is required to move up to 10 pounds and may, at times, be required to move up to 50 pounds.
Licensed Clinical Social Worker (Lcsw)