LTSS Service Care Manager – LCSW, LPC, or Psych RN

Role Overview

• Develops, assesses and coordinates holistic care management activities, with primary focus and support towards populations with significant mental/behavioral health needs, to enable quality, cost-effective healthcare outcomes.
• Evaluates member service needs and develops or contributes to development of care plans/service plans, and educates members, their families and caregivers on services and benefits available to meet member needs.
• Evaluates the needs of the most complex and high risk members with mental/behavioral health needs, and recommends a plan of care for the best outcome.
• Acts as liaison and member advocate between the member/family, physician, and facilities/agencies.
• Supports members with primarily mental/behavioral health needs, such as those with (or a history of) major depression, bipolar disorders, schizophrenia, borderline personality disorder, post-traumatic stress disorder, substance use disorder, self-injurious behavior, psychiatric inpatient admissions, etc.
• Performs frequent home and/or other site visits (once a month or more), such as to assess member needs and collaborate with resources, as required.
• Provides and/or facilitates education to long-term care members and their families/caregivers on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, and healthcare benefits.
• Provides subject matter expertise and operational support for relevant mental and behavioral health-focused activities, such as the handling of crisis calls, mental health first aid training, field safety and de-escalation practices, psychotropic and other medication monitoring, etc.
• Educates on and coordinates community resources, to include medical, behavioral and social services.
• Provides coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living).
• Ensures appropriate referrals based on individual member needs and supports the identification of providers, specialists, and community resources.
• Ensures identified services are accessible to members.
• Maintains accurate documentation and supports the integrity of care management activities in the electronic care management system.
• Works to ensure compliance with clinical guidelines as well as current state and federal guidelines.
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner.
• Performs other duties as assigned.
• Complies with all policies and standards. Travel is required for In-Person member assessments.

Requirements

• Requires a Master's degree in Mental Health or Social Work or Graduate from an Accredited School of Nursing and 2 – 4 years of related experience.
• REQUIRED Licensed Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LPC, or RN with Behavioral Health experience
• 3+ years of case management, care coordination, discharge planning with adult populations (ages: 18
• 2+ years of experience coordinating and managing healthcare/behavioral health services and personal assistance/social services, and providing patient advocacy and education to Medicaid members
• Experience in FIELD-BASED Social Worker or Case Managers role in-patient behavioral health hospital, community health, outpatient mental health, substance abuse/ detox recovery treatment, or state social services settings (MHAs, LIDDA) is preferred.

Benefits

• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• flexible approach to work with remote, hybrid, field or office work schedules