Description
JOB SUMMARY
This job provides telephonic integrated behavioral and physical health case and condition management services to members with mental health, substance use, and co-morbid chronic medical conditions.
Behavioral health conditions include serious mental illness, untreated mental health, alcohol use, and opioid use. The incumbent uses clinical and motivational interviewing skills to assess both behavioral and physical health needs, and social determinants of health to establish mutually agreeable short and long-term health goals.
- They support members in developing self-management skills and adopting positive behavior change; identify and address gaps in care;
- resolve barriers to evidence-based care; help members coordinate their comprehensive healthcare services and navigate the healthcare system;
and identify on-line, telephonic, and community-based resources. The overall goal is to help members navigate the health care system and develop condition self-management skills through behavior change
ESSENTIAL RESPONSIBILITIES
Function as a primary contact for members with Opioid Use Disorder (OUD) / Behavioral Health with co-morbid medical conditions including pregnancy to provide intensive case management interventions.
Provide members with resources and tools to assist in health-related decision making. Conduct clinical and psycho-social assessments telephonically or in the community that address the health and wellness needs of the Organization's members.
Collaborate with case and condition management teams to provide co-management activities for members who require additional services.
Participate in ongoing training and educational activities related to behavioral health and medical topics. Pro-actively incorporate lifestyle improvement and prevention opportunities into member interactions and coaching.
Provide education on evidenced based treatment.
Utilize standard case management approach to manage members’ conditions (Motivational interviewing; Develop plans of care;
Establish a plan for contact to review progress / assess needs; Communicate with treating provider(s); Identify community-based resources for long-term maintenance).
- Assess for social determinants of health and link members with community resources to eliminate barriers.
- Collaborate with key community and clinical partners.
- Other duties as assigned or requested.
EDUCATION
Required
- High School Diploma / GED with RN license
- Master’s Degree if Licensed Behavioral Health Professional or Licensed Social Work
Substitutions
None
Preferred
None
EXPERIENCE
Required
5 years of Post licensure experience in any combination of behavioral health clinical, case management and / or condition management
Preferred
- 5 years of Advanced training and experience in cognitive behavioral therapy (CBT) and or DBT
- 5 years of Experience working with healthcare needs of populations with SMI and substance use disorders
- 5 years of Experience working with the healthcare needs of diverse populations
- 5 years of Understanding of the drug and alcohol system, harm reduction and community resources
- 5 years of Crisis management
- 5 years of Understanding how SMI, addiction, and medical co-morbidities affects families
- Proficiency in a second language
LICENSES or CERTIFICATIONS
Required
One of the following :
- Registered Nurse (RN)
- Licensed Professional Counselor (LPC)
- Licensed Clinical Social Worker (LCSW)
- Licensed Social Worker (LSW)
- Licensed Marriage and Family Therapist (LMFT)
Preferred
- Certified Case Manager
- CAC - Certified Addiction Counselor
SKILLS
- Advanced knowledge of motivational interviewing and stages of change
- Proficiency in utilizing PC-based system application and reporting packages, especially Microsoft Office application
- Understanding of confidentiality laws as they pertain to Drug and Alcohol and Behavioral Health
- Knowledge of evidenced based practices as it relates to treatment of SMI / OUD / behavioral health
- Excellent verbal and written communication skills as well as the ability to manage multiple priorities in a rapidly changing environment
Languages (Other than English)
None
Travel Required
None
PHYSICAL, MENTAL AND WORKING CONDITIONS
Position Type
Office Based
Teaches / trains others regularly
Does Not Apply
Travel regularly from the office to various work sites or from site-to-site
Occasionally
Works primarily out-of-the office selling products / services (sales employees)
Never
Physical work site required
Lifting : up to 10 pounds
Rarely
Lifting : 10 to 25 pounds
Rarely
Lifting : 25 to 50 pounds
Never
Pay Range Minimum : $67,500.00
$67,500.00
Pay Range Maximum : $124,800.00
$124,800.00
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation / gender identity or any other category protected by applicable federal, state or local law.
Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation / gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities / Women / Protected Veterans / Disabled / Sexual Orientation / Gender Identity ()
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