Care Manager in Charleston, WV at Beacon Health Options

Date Posted: 10/19/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Care Manager to join our team at our office in West Virginia.  The Care Manager (CM) will use clinical, NCQA and CMSA standards to provide care management to Beacon members on an ongoing basis within the members benefit package. The CM will initiate and maintain communication with members, Primary Care Physicians, Behavioral Health Providers, medical care managers and other health team members regarding the care management plans and collaborate to meet the members’ needs.

Position Responsibilities:

  • Triage and manage members referred to Case Management identified as ICM who may be high risk, high utilizing, at significant clinical risk or under-utilizing services.

  • Responsible for coordination of care and collaboration with members and providers for members in lower levels of case management to assist members in accessing the most clinically appropriate, least restrictive care available.

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

  • Demonstrate effective prioritization and follow-up skills in managing caseload.

  • Complete comprehensive assessment of the medical, behavioral health and psychosocial needs of identified members and establishing.

  • Create person-centered and culturally competent Individualized Care plan (ICP) to include problem identification, goal-setting, interventions and expected outcomes

  • Facilitate and coordinate the appropriate services and supports to meet the member’s perceived needs.

  • Provide health coaching and education to members related to health care conditions and treatment plans with a focus on medication and treatment adherence, appropriate use of emergency room, and navigation of the health care system.

  • Direct members to self-management tools and resources and support in their use.

  • Collaborate with medical and social care managers and Pharmacy to develop a comprehensive and integrated approach to care coordination.

  • Participate in rounds forums to promote integrated case discussions and problem-solving

  • Make timely referrals for community based services.

  • Document care management activities in FlexCare and /or Health Plan Electronic Health Record according to Beacon Standard Operating Procedures.

  • Complete care management activities in a timely manner and meet compliance requirements for the state Medicaid regulatory HSAG, Medicare NORC, NCQA, and Beacon Clinical Management department standard operating procedures.

  • Provide assistance, advocacy, and empowerment to members in efforts to achieve optimal health.

  • 5% travel

Position Requirements:

Education:    

  • Master’s Degree in a behavioral health related field or BSN Required

Licenses:

  • Have either: A current, valid, unrestricted independent license in behavioral health field (including LCSW, LCPC, clinical psychologist, LMFT) OR current, valid, unrestricted independent nursing license (BSN) and practice within the scope of their licensure

Years and Type of Relevant Work Experience:

  • Minimum of three (3) years of combined direct behavioral health clinical and/or behavioral health managed care experience with familiarity with Medicaid and Medicare populations.

  • Educated in current principles, procedures and knowledge domains of case management based on nationally recognized standards of case management

Knowledge, Skills & Abilities:

  • Excellent computer skills

  • Strong analytical and problem solving skills

  • Strong written and verbal communication skills

  • Detail oriented and able to work independently

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

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