Behavioral Health Care Manager, Licensed – Crisis Queue

Role Overview

• Establish and continuously model supportive and collaborative relationships with members, colleagues, and external partners.
• Model the highest ethical behavior in care for Members, as well as in relationships with co-workers, Leaders, internal, and external partners.
• Model commitment to continuous quality improvement by engaging in quality improvement initiatives and projects, such as by identifying and addressing HEDIS gaps, and by identifying, developing, and testing new practices for improving the outcomes of the Enhanced Care Management team.
• Participates in Health Plan staff meetings, trainings, committee meetings, or other activities as needed or as directed by Leadership Team Members.
• Working in a lead training capacity by providing formal and informal clinical training and other learning and development activities to support department Team Members on behavioral health conditions, including treatments and evidence-base for treatment (within areas of expertise/scope) as well as provide onboarding and ongoing training to department Team Members.
• Promote a collaborative and effective working environment within the department or those outside BH discipline by engaging in evidenced-based communication strategies (such as Motivational Interviewing) when discussing responsibility/sharing of tasks, effectively resolving conflicts as they arise, and collaborating on Member case discussions to provide integrated care to IEHP members.
• Participate in committees, conferences, and any other meetings as required or directed by department managers or directors.
• Responsible for primarily working with a caseload of Members with behavioral health needs.
• Advocate for Members to receive the highest quality care, in a timely manner, within IEHP’s network by referring to appropriate internal partners such as behavioral health, Enhanced Care Management, and complex care management.
• In conjunction with department leadership, the Licensed Behavioral Health Care Manager is responsible for providing consultation for the non-licensed Members of the team when discussing tasks of a clinical nature.
• Responsible for engaging with Members to provide effective care management, both in-person and on the phone, including linkage to resources and support in transitions of care, in a manner that utilizes evidence-based approaches (such as Motivational Interviewing) that promotes collaboration between the Member and his or her medical/behavioral team, facilitating member self-efficacy and self-management to improve the Member’s ability to manage their own health, and all other activities associated with high quality, evidenced-based care management.
• Ensures documentation is accurate and in compliance with regulatory requirements and accreditation standards.
• Assist Members with care coordination needs, including, but not limited to the following: Conduct comprehensive, holistic assessment both telephonically as well as in person (facility or home visits). Assimilate assessment information to assist, in collaboration with the ITC Team and the facility, in developing a discharge plan or an individualized care plan (ICP). Communicate ICP or discharge plan with Member, approved family or caregiver and other Members of the care team. Coordinate with internal and external health partners to support Members’ comprehensive care needs. Assists with the coordination of medical and behavioral health access issues with PCP offices, specialists, and ancillary services. Participate in inter/transdisciplinary care team meetings to share information, update and inform care plan. Participate and lead (as necessary) care transition plan responsibilities. Engage in proactive, member-centered utilization and quality review of Behavioral Health services by members. Provide crisis intervention to individuals, as well as providing support and clinical guidance to others who engage in this work. Responsible for any other duties as required to ensure successful care management processes and Member outcomes. Provide transitional care services to Members transitioning from one care setting to the next such as assisting the Member with PCP appointments, transportations, and coordination of DME and home health. Support Member through all care transitions by making outreach to ensure all care needs are met before closing the Member out to transitions of care. providing care coordination, linkage to resources, and facilitating Member self-efficacy and self-management. Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Requirements

• Minimum of three (3) years of experience performing or facilitating Behavioral Health/Medical Social Work services
• Experience in motivational interviewing and/or other evidenced-based communication strategies
• Experience working successfully within a team, and experience in developing and maintaining effective relationships with both clients and coworkers is mandatory
• Behavioral Health/Medical Social Work services experience in a health clinic psychiatric hospital, medical facility, or health care clinic strongly preferred
• Experience in clinical services, both mental health and substance use preferred
• Master’s degree in Social Work or related field from an accredited institution required
• Possession of an active, unrestricted, and unencumbered license in a Social Services related field issued by the California Board of Behavioral Sciences required (LCSW or LMFT preferred)

Benefits

• Competitive salary
• CalPERS retirement
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance