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CARE MANAGER in Worcester, MA at Beacon Health Options

Date Posted: 12/5/2018

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic INTENSIVE CASE MANAGER to join our growing team in the Worcester, MA area!

The Intensive Case Manager is responsible for outreaching, triaging, assessing, and managing of members referred to Case Management. Responsible for the tracking and managing of members identified as Intensive Case Management (ICM) who may be high risk, high utilizing, at significant clinical risk or under-utilizing services. 

Position Responsibilities:

Engaging and supporting members

  • Meet strict deadlines and established cycle times through effective prioritization and follow-up skills in order to provide excellent care management services to all members assigned to ICM caseload
  • Meet defined engagement rates as outlined per contract and type of business (ex. 30% engagement for all referrals for one contract)
  • Identify members for the care management program as assigned
  • Utilize strong clinical assessment skills for members who are identified or referred
  • Demonstrate knowledge about services and utilize creativity to consider how to meet member's needs
  • Ensure members have support in transitioning from care to ensure their treatment is coordinated and not disrupted
  • Demonstrate experience establishing relationships and effectively engaging with members and providers through telephonic communication to obtain necessary information for the purposes of care management and coordination
  • Seek supervision and consultation as needed
  • Safely and appropriately manage all member calls including emergency and crisis situations

Drive positive outcomes for members as defined by contract and type of business

  • Ensure successful discharges from Beacon's care management program due to member meeting mutually set goals
  • Increase community tenure
  • Improve rates assessed by regional or contract performance improvement programs
  • Collaborate with community based providers and other collateral sources
  • Assist in collection of outcomes information, annual analysis and other reporting and initiatives

Clear and accurate documentation of work

  • Document assessments, care plan, and care plan intervention thoroughly
  • Adhere to policy and procedure to ensure that documentation is in accordance with NCQA and other regulatory standards
  • Timely and accurate completion on all documentation according to accreditation, member needs, and contract standards
  • Sufficient documentation of high risk and emergency situations

Position Requirements:

Education: Master’s degree or higher in a health related field OR BSN with at least 3 years of psychiatric experience

Licensures: Have either a current, valid, unrestricted independent MA license in behavioral health or nursing (RN) and practice within the scope of their licensure

Relevant Work Experience: Minimum three (3) years of combined direct behavioral health clinical and managed care experience           
 

Knowledge, Skills & Abilities:

  • Demonstrated experience establishing relationships and effectively engaging with members and providers through telephonic communication to obtain necessary information for the purposes of care management and coordination
  • Demonstrated work experience meeting strict deadlines and established cycle times through effective prioritization and follow-up skills.
  • Case Managers are required to be educated in current principles, procedures and knowledge domains of case management based on nationally recognized standards of case management and must be a licensed behavioral health clinician or RN All case managers must practice within the scope of their license.
  • Excellent written and oral communication skills

TO APPLY

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

Beacon Health Options company is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

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