Care Manager in Rocky Hill, CT at Beacon Health Options

Date Posted: 7/23/2019

Job Snapshot

Job Description

The Child Intensive Care Manager will be responsible for applying specialized care management techniques in the clinical management of intensive, chronic, or complex cases and when an individual (child or adult) experiences barriers to recovery. Knowledge of the treatment of mental disorders for chronically ill patients and substance abusers is required as is an understanding of the basic concepts of managed behavioral health care.  Duties include evaluation, determination and authorization of appropriate levels of care based on established criteria for Medicaid and DCF consumers.

Position Responsibilities:

  1. Mediates advocates, negotiates with care providers, and engages additional providers when needed in order to improve individual outcomes for a Member.
  2. Collaborates with the Department of Children and Families and the Department of Social Services as necessary to improve outcomes for a Member.
  3. Participates in multidisciplinary team reviews when convened to review existing care plans to ensure they adequately address the complex behavioral health issues.
  4. Responsible for the intensive care management of designated Members who meet ICM criteria in a designated DCF local area; will at times work out of a local area office when space is available.
  5. Works no less than 20% of the time in the field providing care management services and consultation.
  6. Builds, develops and maintains a positive and collaborative relationship with local providers by establishing a local presence.
  7. Establishes a plan, in collaboration with Member’s primary behavioral health provider, the Member, and/or other providers as necessary for addressing barriers to care.
  8. Supports and directs clinical care-decision making at a local level by supporting the meaningful participation of families and consumers in directing their own care.
  9. Applies state-of-the-art techniques in managing service delivery with objective, standardized clinical protocols and the outlier management program.
  10. Works closely with the System Managers in identification of over or under utilization of services, gaps in services and effective/ineffective treatment approaches.
  11. Works collaboratively with the Peer Specialists by offering their services to Members where such services are requested or appropriate according to the Member’s needs and interests.
  12. Reviews clinical information, on-site and telephonically, regarding requests for authorization for payment of care.
  13. Evaluates clinical information and document justification for authorization in computerized medical records system.
  14. Provides EPSDT case management when needed by facilitating referrals, developing and coordinating a plan of service.
  15. Summarizes and presents written and oral clinical information to supervisor, medical director or peer advisor in one-to-one and group settings.
  16. Utilizes established policies and procedures for processing authorizations and initiating Member appeals and claims reviews.
  17. Consults with providers on Member/family education regarding treatment goals and objectives, medication, and social skills. 
  18. Contributes to and documents individualized care plans. 
  19. Recommends discharge plans, aftercare referrals, and community resources.
  20. Consults with providers to assist Members with transportation and employment issues and daily living needs as they relate to individualized care plans.

Knowledge, Skills & Abilities:

  • Expert and proficient knowledge, skill, and ability in MS word, MS Excel, MS PowerPoint, MS Outlook, and MS Project.
  • Analysis and problem solving, Interpersonal communication, verbal and written communication, Group presentation/public speaking, and Collaboration and team oriented work philosophy.

 Beacon Health Options 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.

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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