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CARE MANAGER (CA License Required- RN, LCSW, MFT, LPCC, PhD or PsyD) in Downey, CA at Beacon Health Options

Date Posted: 5/7/2019

Job Snapshot

Job Description

ABOUT THE POSITION,
We are currently seeking a dynamic Care Manager to join our team at our office in Cerritos, CA and Downtown LA.  The Care Manager is the health professional (Psychiatric RN or other independently licensed Behavioral Health Clinician) for the Dual Eligible program responsible for the coordination of integrated, seamless and person-centered service in support of members who are dually eligible under Medicare and Medicaid programs.

 Require commuting 20% out in the field within to LA County area. 

Position Responsibilities:

The Care Manager provides holistic assessment and care, as well as complex care planning and management services. The Care Manager will coordinate among all Interdisciplinary Care Team (ICT) members to develop the Individualized Care Plan (ICP) and oversee ICP implementation by the Care Coordinator. S/he is available to the health plan and community based Case Management provider agencies for consultation when issues with regard to behavioral health management or treatment arise. The Care Manager provides clinical oversight for Care Coordinators, Community Health Workers and other paraprofessional staff responsible for implementing the Individualized Care Plan (ICP). Additionally the Care Manager is responsible for authorization of services and coordination of care with any contracted community based Case Management agency when appropriate. The Care Manager remains current in Case Management Society of America (CMSA) evidence based protocols, as well as the care management requirements and responsibilities of the dual demonstration project.

1. Facilitate clinical policies implementation and maintenance, assess training and development needs for, and identify clinical resources and tools to improve program effectiveness and quality. S/He will be responsible for maintaining accurate information in Beacon’s and the Health Plan’s clinical documentation systems as directed;

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

3. Provide coaching to Care Coordinators and Service Coordinators related to clinical decisions and outcomes;

4. Identify, assess, and holistically manage complex behavioral health cases for those members who are in the dual eligible program as appropriate;

5. Provide individualized person-centered support to members. Provide health coaching and wellness education as appropriate;

6. Develop or oversee the ICP for each member in collaboration with all team members, adhering to timelines and including assessment of health needs, individualized care management plans, implementation, monitoring and evaluation of care outcomes;

7. Collaborate with Primary Care Physician (PCP), Behavioral Health Professionals (BHP), and other members of the health care team, Health Plan Medical Care Managers, consumer advocates, Pharmacy, and others to arrange and coordinate services for the member to help member reach their highest level of functioning and optimize the member’s ability to engage in the appropriate plan of care;

8. When delegated, oversee activities associated with member welcome and orientation. Ensure that initial member assessment and annual updates are completed and documented; 9. Assess caseloads and modify as needed;

10. Utilize the evidence based guides to identify problem areas;

11. Collaborate with health plan medical lead when problems are identified;

12. Collaborate with the Care Coordinator to update ICP as necessary;

13. Authorize medically necessary services in ICP;

14. Review medications at time of care transition;

15. Complete the Beacon or Health Plan Health Risk Assessment (HRA) ongoing assessments per contractual agreement with the health plan;

16. Manage and coordinate care. May conduct in-home assessments of barriers to health condition management, and conduct facility visits to meet members receiving in-patient behavioral health care to assist with discharge planning and engagement activities;

17. Other duties as assigned.

Position Requirements:

Education:  BSN or higher, Master’s level in a behavioral health discipline: social work, counseling, psychology preferred.

Licensure: 

  • Have either a current, valid, unrestricted independent license in behavioral health or nursing (RN) with proof on date of hire and practice within the scope of their licensure.

  • Re-verification will take place no less than every 3 years. Valid California State Clinical License required (RN, LCSW, MFT, LPCC, PhD or PsyD)

Relevant Work Experience:  

Minimum of five (5) years of combined direct behavioral health clinical and managed care experience or community service required. Call center and customer service experience a plus

Knowledge, Skills & Abilities:

  • Demonstrated experience establishing relationships and effectively engaging with members and providers through telephonic communication to obtain necessary information and facilitate care in multiple settings.

  • 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 skills.
  • 2 days in the  Downey, Cerritos or Downtown LA office and 20% field work in Los Angeles area (including IP facilities)
  • Bilingual preferred (Spanish)

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

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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