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Clinical Care Manager in Latham, NY at Beacon Health Options

Date Posted: 3/19/2019

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Clinical Care Manager to join our team at our office in Latham, NY!  The Clinical Care Managers (ICM CCM) , licensed behavioral healthcare clinicians operate within a multidisciplinary unit and include Licensed Clinical Social Workers, Licensed Professional Counselors, Licensed Marriage and Family Therapists, Psychologists or Licensed Registered Nurses. All CCMs have at least 3 years clinical experience, which includes client direct contact experience. The CCM report to supervisor of Clinical Care Management services. The CCMs will conducts telephone assessments, collecting sufficient data to make appropriate referral and authorization decision for emergency, urgent, and routine levels of care.  Makes appropriate utilization management decisions.  Collaborates with providers to determine alternate levels of care and to facilitate transfers to network facilities and providers whenever possible.  Facilitates coordination of care with other service managers and aftercare coordinators to assure continuity of care.  Evaluates clinical appropriateness of treatment using professional knowledge within medical necessity guidelines and renders authorization decisions or seeks peer advisor consultations for non-authorization decisions.

Position Responsibilities:

  • Completes telephone assessments and referrals; gathers demographic and clinical information to connect member with appropriate provider, including outpatient treatment as necessary; and for emergency, urgent, and routine referrals
  • Reviews for medical appropriateness psychiatric/substance abuse cases utilizing professional knowledge to apply medical necessity criteria and renders authorization decisions
  • Applies utilization management policies and procedures for determination of initial, concurrent and retrospective review
  • Refers cases that do not meet criteria and need non-authorization decision to Peer Advisor
  • Utilizes rounds and case consultations to Clinical Supervisor and Peer Advisor for quality of care cases
  • Ensures continuity of patient care through contact with providers and assigned individuals
  • Coordinates with other Care Managers to assure that members’ comprehensive treatment needs are met
  • Clinical documentation to reflect recovery principles, active and longitudinal care management interventions and quality of care issues.
  • Develops an individualized member centric comprehensive care plan with input from the member, provider and family. The individual goals include recovery and resiliency, decreasing symptomatology and/or increasing functional ability in areas such as self-care, work/school, and family/interpersonal relations in order to reduce barriers to treatment.
  • Providing monitoring and reviewing of cases through planned outreach, incoming contacts, care coordination and utilizing rounds, weekly reports and individual supervision.
  • Coordinating and consulting with the other Care Manager and medical care management as necessary Attending regularly scheduled rounds to consult with a psychiatrist or health plan staff and discuss cases and the need for continued intensive care management and outreach. Sending outreach letters to members who are not telephonically accessible or who do not res pond to multiple telephonic outreach attempts.
  • Frequency of outreach to the member, supports and provider(s) occur at a minimum one time per month, but more may be scheduled according to the member’s clinical needs.
  • Member’s progress and CM interventions are documented appropriately in the care management system.
  • Providing case closure/discharge at the time of completion.
  • Follows all work flows meetings regulatory and accreditation requirements.
  • Maintain a consistent caseload within parameters as defined by clinical leadership. Communicate as needed with clinical supervisor to address caseload
  • Provide onsite case management, as assigned, to facilitate face-to-face interventions with providers and members.
  • Providing consultation and coordination with the behavioral health or medical providers, facility or, family members, s, community agencies, or involved medical practitioners regarding treatment and/or treatment planning issues.

Position Requirements:

Education : A minimum of a B.S. Degree in mental health field or an Associate’s Degree in Nursing with related psychiatric nursing experience

Licensure : Current valid and unrestricted license in a state or territory of the United States in a mental health field (RN, Ph.D., LMSW/LCSW, MHC, LLP, LPC, etc.) License in NY.
 

Relevant Work Experience: 3 – 5 years of direct practice experience in settings that include inpatient, partial, and/or outpatient required.  Experience working within the NYS Children’s Medicaid system preferred.  Must possess strong computer skills.


Knowledge, Skills & Abilities :

  • Analysis and problem solving
  • Collaboration and team-oriented work philosophy
  • Interpersonal communication

TO APPLY

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

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

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