Clinical Care Coordinator I in Louisville, KY at Beacon Health Options

Date Posted: 7/26/2019

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Care Coordinator to join our team out of Louisville, KY.  The Care Coordinator, under the clinical supervision of a licensed Behavioral Health Clinician, provides care coordination to Beacon members in the (assigned program) who are identified and referred to Beacon due to serious and persistent mental illness and/or referred for behavioral health needs. The population includes children and adults (including seniors) who are identified as experiencing a mental health condition which impacts their functioning. Care coordination is provided primarily face-to-face in community settings (homes, inpatient units or Community Service Boards), telephonically, and through research based processes.

The Care Coordinator acts as the single point of contact for an integrated, seamless and person-centered treatment approach to assist members in managing their health care. Responsibilities include outreaching, initiating and maintaining communication with members, community based behavioral health providers, primary care physicians, medical case managers and other interdisciplinary team members to ensure that the members’ behavioral health needs are met.  The Care Coordinator is responsible to complete a comprehensive assessment face-to-face with members using standardized assessment tool(s) to identify needs, strengths and goals. Care coordinators are also responsible to work with the member’s care team on medical and psychosocial needs and goals. The care coordinator is responsible for the member’s Individualized Care Plan (ICP) and active engagement and facilitation of the member’s Integrated Care Team (ICT) process.

The goal for the ICT process is to collaborate, either in-person or through other means, to develop and implement a person-centered Individualized Care Plan (ICP) built on the individual’s specific preferences and needs, delivering services with transparency, individualization, respect, linguistic and cultural competence, and dignity and meets the medical, behavioral, LTSS, early intervention, and social needs of members

Position Responsibilities:

  • Works with the Beacon team to ensure completion of all requirements of the program as outlined by DMAS, including meeting face-to-face with members and ICTs as necessary and appropriate.
  • Acts as the primary point of contact for members who are assigned. This includes educating the member about the program, benefits, obtaining appropriate consent/s, collaborating with the medical care coordinator and conducting all activities in a holistic, person centered manner, and ensuring that referrals result in timely appointments and if not, escalated appropriately.
  • May complete a face-to-face comprehensive assessment on each assigned member at enrollment, annually and / or after a triggering event (i.e. admission), utilizing an approved assessment tool(s). The assessment, ICP and ICT must be completed within specified timeframes and by assigned priority.
  • Assignment of duties may include primary job function of completion of assessments, or a primary job function of ongoing care coordination, or a combination of both, depending on business need.
    1. Meets with the individual and his/her guardian or care provider, as appropriate, to complete the assessment, which may take more than one call/visit, depending on the member’s condition at the time.. if the individual’s condition is too fragile/unstable to tolerate a full assessment in one sitting (whenever possible the assistance of a caregiver or family individual will be elicited to complete the assessment in one appointment).
    2. Makes effort to involve the member, authorized representatives, family members and caregivers in the assessment process. This process includes obtaining signatures on documents, and appropriate consent to participation the process.
    3. Identifies and works with the ICT to ensure accommodations are available to address the needs of members with communication impairments (e.g., hearing and vision limitations) and members with limited English proficiency, in a culturally and developmentally appropriate manner.
    4. Utilizes all available sources, with appropriate consent, to complete the assessment and documents the source of information and location of completion (face to face or telephone and physical location).
  • Engages members in care coordination activities by using a person-centered approach and assists with developing a member’s self-management skills based on their health condition.
  • Communicates with members about their ongoing or newly identified needs at a regular frequency, as defined by policy, to include a phone call or face-to-face meeting, depending on the member’s needs and preferences.
  • Develops and maintains the ICP and makes it accessible to providers and members as needed and upon request revises the ICP based on triggering events, such as hospitalizations or a decline or improvement in health or functional status.
  • Documents all activity in the designated system according to required polices and workflows.
  • Monitors the provision of services, including outcomes, assesses appropriate changes or additions to services, and facilitates referrals for the member. Implements and monitors member adherence and response to the Individualized Care Plan (ICP).
  • With the Beacon team, ensures that appropriate mechanisms are in place to receive member input, complaints and grievances, and secure communication among relevant parties.
  • Employee should be willing to work with their Supervisor on a flexible schedule if meeting the above duties requires appointments outside business hours.

A portion of members considered to be in a vulnerable population (defined by the member’s health status and health condition) may receive additional services in the Enhanced Care Coordination program.

Enhanced care coordination is also provided by the Care Coordinator, and responsibilities include (in addition to the above tasks):

  • Set up appointments and in-person contacts as appropriate
  • Build strong working relationships between care providers, individuals, caregivers and physicians
  • Connect members with evidence-based patient education programs;
  • Arrange transportation as needed;
  • When appropriate, assist with referrals and access to Medicare-covered
  • services
  • Provide enhanced monitoring of functional and health status
  • Provide coordination of seamless transitions of care across health care specialties and settings
  • For Members with disabilities, provide effective communication with health care providers and participate in assisting member with decision making with respect to treatment options
  • For eligible children, coordinate with early intervention providers, including for children who

“age-out” of the early intervention program and need services to continue

  • Connect Members to services that promote community living and help avoid premature or unnecessary nursing facility or other residential placements or inpatient hospitalizations (medical or psychiatric)
  • Coordinate with social service agencies (e.g.; local departments of health, LDSS, AAAs, and CSBs) and referring Members to state, local, and other community resources
  • As part of a team, work with nursing facilities and community-based LTSS providers to include management of chronic conditions and coordination of services beyond the scope of the LTSS benefit.
  • 50% travel

Position Requirements:

Education:

A bachelor’s degree in a health or human services field or Registered Nurse (RN) with one (1) year experience working directly with individuals with complex mental health and/or medical conditions, or;

A Licensed Practical Nurse (LPN) with at least three (3) years’ experience working directly with individuals with complex mental health and/or medical conditions.

Licenses:

In addition to the clinical licensure noted above, valid KY driver’s license, safe driving record, dependable transportation to travel within their regional radius.

Relevant Work Experience: 

Is knowledgeable about locating available services and community resources in a mode and manner that is culturally, developmentally appropriate and that considers the member’s physical and cognitive abilities and level of literacy.

Excellent communication skills, ability to work as part of a team, knowledge of the (State) Medicaid and/or health delivery system, and knowledge of mental health services a plus.

Ability to document within care management system; knowledge of Microsoft Word and Excel.

Ability to work independently and document productivity

Have strong time management and solid organizational skills.

Must have an understanding of challenges facing people with behavioral health conditions and familiarity with the behavioral health service delivery system in (State)

Must be able to manage working remotely and have WiFi capabilities

Must be comfortable working within computer systems

Knowledge, Skills & Abilities:

  • Proficient with Microsoft suite word, excel
  • Analytical and problem solving skills
  • Excellent written and verbal communication skills
  • Group presentation and public speaking skills

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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