CASE MANAGER (LMFT, LICSW, LCSW, RN, LMHC) CLINICAL TEAM LEAD

Job Snapshot

Job ID: 51684

Location: San Jose, CA

Posted: 7/13/2017

Category: General Business, Nurse, Management, Health Care

Experience: Not Specified

Education: See Requirements

Job Description

Ability to work from home 2 days out of the week

ABOUT THE POSITION

We are currently seeking a dynamic Care Manager Team Lead to join our team at our office in  San Jose, CA.  The Care Manager Team Lead must hold a valid CA Clinical License and will be responsible for provides comprehensive management of the Case Management Team and facilitates the delivery of the highest standards for the Case Management Program, quality outcomes and operational efficiencies.

Position Responsibilities:

  1. Leads the Case Management Team by directing the activities of team members, drawing upon referral criteria and clinical expertise to manage all aspects of Case Management

  2. Assists with the design, development, modification, of workflows for the Case Management Team.

  3. Supports the development of solutions for issues and presents recommendations to the Clinical Manager and/or Clinical Director.

  4. Assist in establishes goals and objectives for the CM Team and individual team member roles and responsibilities.

  5. Possesses and maintains in-depth knowledge of workflows, products, program components.

  6. Troubleshoots for problems and submits recommendations. May be required to interface with other areas, either internally or externally, to effectively resolve problems.

  7. May provide direct supervision of staff, including performance reviews.

  8. Work collaboratively to coordinate a supportive environment and clear communication;

  9. Maintaining accurate information in Beacon’s clinical documentation systems as directed

    Assist in collection of outcomes information, annual analysis and other reporting and initiatives

  10. Telephonic collaboration with provider and county agencies regarding members in care management

  11. Participation in systems meetings as needed

  12. Collaborate with Primary Care Physician (PCP), Behavioral Health Professionals (BHP), and other members of the health care team, including health plan medical care managers, Pharmacy, and others to arrange and coordinate services for the member and optimize the member’s ability to engage in the appropriate plan of care;

  13. Developing or overseeing a plan of care for each assigned member, adhering to timelines and including assessment of health needs, individualized care management plans, implementation, monitoring and evaluation of care outcomes;

  14. Assist with NCQA and URAC initiatives

  15. Urgent calls

  16. Telephonic collaboration with Members

  17. Treatment Record Reviews

  18. Attend Clinical meetings

  19. Other duties as assigned

Position Requirements:

Education:  Master’s degree or higher in a health related field and licensure as a behavioral health professional.

Licensure: LMFT, LICSW, LCSW, RN, LMHC

*Work from home 2 days out of the week

Relevant Work Experience:  

Current, valid and unrestricted licensure for independent practice required with proof on date of hire. Re-verification will take place no less than every 3 years. A minimum of LMFT, LICSW, LCSW, RN, LMHC, with 5-7 years combined direct behavioral health, supervisory and/or managed care experience required. 

Knowledge, Skills & Abilities:

  • Demonstrated work experience to influence and negotiate to effectively manage patient care and health care outcomes.

  • Demonstrated work experience meeting strict deadlines and established cycle times through effective prioritization and follow-up.

  • Educated in current principles and procedures of behavior health care.Knowledge of managed care and state specific expertise preferred.

  • Strong interpersonal skills and good written and verbal communication skills.

  • Advanced computer skills required, including working knowledge of MS Office: Word, Excel, and PowerPoint

    TO APPLY
    Click below on “Apply for this Position” to create a profile and apply for the position

    Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled
     

    #CB

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Job Requirements

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  • 5,000 employees nationally and in the U.K.,serving more than 48 million people.
  • My team at Beacon Health Options welcomed me immediately. Collaborating with so many talented individuals within the organization gives me a daily opportunity to see the great work we do in action. - Proposal Specialist, Norfolk, VA
  • Over 350 clients, including 225 employer clients, 45 Fortune 500 companies and partnerships with almost 100 health plans
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