Remote Temp to Hire Clinical Care Coordinator
Our client, an NCQA accredited managed behavioral healthcare organization, has a need for a 100% remote LCSW / LCPC Clinical Care Coordinator (CCC).
The CCC participates in the Implementation of the Utilization and Population Health Management Program, supports Quality Management initiatives, and the Recovery model of care with a holistic approach to meeting the needs of the CCC’s caseload while following their patients through the continuum of care.
The CCC reports to and collaborates with the Senior CCC and Medical Director / Physician Champion to provide quality care and services.
Roles and Responsibilities :
- Fully understands policies, procedures and organizational operations including Apollo Medical Necessity Criteria and ASAM criteria, URAC, NCQA, JCAHO and HEDIS standards and Health Plan or Medical Group requirements.
- Utilizes the most current clinical and level of care criteria as approved by Peer Review Committee and Executive / QI Committee.
- Manages and coordinates member benefits and individualized treatment delivery for optimal patient outcomes in CM / CCM program, then post program discharge across the continuum of care.
- Participate in team, meetings, training, staffing and educational sessions. including weekly clinical team meetings.
- Identifies Members meting Criteria for the PHM / Virtual Wards program. Facilitates enrollment (outreach via telephone, email, written notice of invitation) and completion of the Initial Assessment.
Education, Experience, and Credentials :
- Master’s degree in Psychology, Social Work, Counseling (or related mental health field) from an accredited college or university.
- Minimum of three (3) years’ experience in direct patient behavioral healthcare.
- Minimum of two (2) years’ experience in case management, discharge planning, and / or utilization review.
- Computer skills and typing proficiency a must. Microsoft Excel and Access background a plus.
- Maintains knowledge and understanding of URAC, NCQA, JCAHO and HEDIS standards.
- Current, unrestricted clinical license, to practice medicine or a health profession that is issued by any state or jurisdiction in the United States;
and 2) required for the performance of the job functions and / or Certified AODA Counselor (CADC)
If you or anyone you know is interested, qualified and available, please send resumes to us for immediate consideration.
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