Clinical Care Manager in Rocky Hill, CT at Beacon Health Options

Date Posted: 6/28/2019

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Clinical Care Manager to join our team at our office in Rocky Hill, CT!  The Clinical Care Manager will perform an integral role by facilitating high quality, cost effective managed behavioral health care for members. The Clinical Care Manager functions as part of an interdisciplinary team designed to meet the needs of the Partnership’s population. The goal of care management is to enhance member and provider participation in the plan of care and to maximize continuous, comprehensive and coordinated care for each identified enrollee. The Clinical Care Manager works in the context of a Call Center and manages member and provider requests for information as well as the clinical authorization process.  

Position Responsibilities:

  1. Addresses member and provider issues telephonically. The majority of the Clinical Care Manager’s work is handled telephonically.
  2. Responds to member’s crisis by providing crisis counseling, referring to providers or community resources to assess member needs, and reviewing requests for service authorizations for designated services.
  3. Provides prior authorizations, peer reviews and referrals to facilities, providers and group practices and other services as appropriate.
  4. Provides comprehensive evaluation and treatment planning by providing concurrent reviews and discharge planning for continuity of care to members.
  5. Presents and reviews cases with the Medical Director and Associate Medical Directors to promote member treatment and aftercare.
  6. Responds to referrals for service from a variety of sources.
  7. Manages appropriate levels of care by gathering information regarding the psychosocial care management plan as indicated for complex needs members.
  8. Researches and refers to appropriate community resources to address needs impacting member's health, safety or ability to access care that cannot be met through contracted benefits.
  9. Develops collaborative relationships with providers to deliver appropriate and timely health care services. Establishes relationships with identified members, family and social support systems when indicated.
  10. Helps develop and facilitate implementation of the most cost effective plan of care for identified members while helping to ensure that members receive high quality care.
  11. Advocates for member’s needs to facilitate movement through systems both internal and external to the organization.
  12. Initiates and/or participates in patient care conferences with other health care professionals.
  13. Attends conferences/in- service presentations to maintain licensure.
  14. Provides in-service sessions to clinical staff presenting information from conferences.
  15. Provides care management services in a caring, professional and responsive manner.
  16. Provides EPSDT care management when needed by facilitating referrals, developing and coordinating a plan of service.
  17. Participates in quality management activities through documentation reports, Inter-rater Reliability testing and audits.

Position Requirements:

Education: Masters degree required

Licensure:  Required to be independently licensed in Connecticut in one or more of the following: Social Work-LCSW, Licensed Professional Counselor-LPC, Marriage and Family Therapist-LMFT, or Registered Nurse-RN.

Relevant Work Experience: Two years’ post licensure experience in the delivery of social work/counseling services in a behavioral health care or home health setting is required. Knowledge of local community resources is essential. Working knowledge of care management principles and practices, cost containment principles, excellent PC skills, analytical and problem solving skills needed. Managed care experience is a benefit.

TO APPLY

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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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