Behavioral Health Care Manager
EPITECChicago, IL, United Statesjob_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_descriptionDischarge care coordination, episodic case management and pre-admission / post discharge counseling and identification of alternate treatment options. Consult with physicians, providers, members, and other resources, as appropriate. Personalize outreach / engagement based upon attitudes / behaviors / risk assessment. Outreach to provider to coordinate the member's care or to notify of risks / new conditions. Reconcile, educate and monitor adherence to medication safety. Reinforce provider post-operative instructions for care, diet, activity level etc. Address barriers to keeping follow-up appointments with appropriate provider and assistance with appointment scheduling. f. Assistance finding a primary or specialist provider, a Blue Distinction Center or any needed coordination with Customer Service. Assist with getting to a provider if needed when all other options have been exhausted. Referral to other BCC programs, or external resources community-based organizations, transportation, home health etc. Provide on-site face to face intervention in select cases. Education and recommendations to resolve conditions and risks, and support for behavior change / self-management. Collaborate with the provider and member when appropriate to develop alternate plans of care if needed. Assist members / providers to navigate the health care system. m. Assess cases for quality-of-care issues and refer cases to the QA / QI department for review and follow up. Perform Transition of Care services for all assigned lines of business. Determine case complexity and may refer to Case Management / Disease Management / Enterprise Lifestyle Management department personnel as necessary. Practice within the scope of licensure. Participate as preceptor for orientation of new employees. Maintain licensure and maintain and enhance knowledge for designated area of licensure and regulatory standards by attending seminars, training sessions, etc. Communicate and interact effectively and professionally with co-workers, management, customers, etc. Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies. Maintain complete confidentiality of company business. Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested. Registered Nurse (RN) or Licensed Master Social Worker (LMSW) with current, active, unrestricted license in the state of operations (or reciprocity if applicable). 2 years clinical experience. 1 year health insurance / managed care experience. Knowledge of medical management policies and procedures. PC and database experience. Verbal and written communication skills. Customer service skills and interpersonal skills to discuss pre / post admission care with physicians, hospital staff and members. Ability and willingness to occasionally travel within assigned location. Possess transportation and current, valid driver's license for applicable state.
Position : Care Management Specialist
Compensation : $39 / hr
Location : This is remote, visiting members (one in Chicago and one Rockford); training will require some onsite days
Job Type : 3-month W2 contract with the potential to be extended or converted to direct
BASIC FUNCTION :
- This position is responsible for discharge care coordination, episodic case management and pre-admission / post-discharge counseling for an acute condition.
- This position is responsible for handling duties in an independent manner and may assist other staff.
- Establish relationship with the member through the immediate post discharge follow-up period or until all short-term care needs are met.
- Provide education / local resource information and encourage member (self) education.
- Determine case complexity and refer to other internal departments as needed.
ESSENTIAL FUNCTIONS :
REQUIREMENTS :
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Behavioral Health Manager • Chicago, IL, United States
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