Behavioral Health Intensive Care Management Coordinator

Job Description:

• Serve as an Intensive Case Manager for members identified with specific conditions
• Perform assessment, planning, facilitation, coordination, monitoring, evaluation, and advocacy of assigned members
• Collaborate and communicate with members, families/caregivers, and healthcare professionals
• Align care coordination and case management activities with members' risk levels, strengths, preferences, needs, and desired outcomes
• Assist with implementation of health management activities and programs
• Coordinate all aspects of assigned programs
• Complete in-person assessments in members' residences or least restrictive environments
• Participate in meetings concerning members' care
• Utilize patient-information data systems and document information appropriately
• Develop strategies to increase effectiveness and participation in health management programs
• Establish and maintain communications with provider networks, group representatives, and members
• Conduct monthly, quarterly, and annual report research and analysis
• Adhere to NCQA requirements, state/federal regulations, and CMSA standards
• Monitor member compliance, success rates, and quality indicators
• Identify needs for health management programs and develop programs for improvement
• Develop patient/provider educational materials
• Perform other duties as assigned

Requirements:

• Four years of recent clinical experience in a defined Behavioral Health specialty area, or 4 years of Behavioral Health utilization review/case management/clinical experience, with 2 years clinical
• Bachelor's degree from an accredited university or college in Nursing, Health Administration, Health Promotion, Exercise Science, Education/Training, Social Work, or a health-related field, with minimum 45 documented training hours related to specialty area issues and treatment
• Behavioral Health Intensive Case Manager degree equivalency: 4-year degree in nursing, psychology, social work, early childhood education, child development, or related field, with minimum 45 documented training hours related to specialty area issues and treatment
• At least 3 years' experience working with people with specified health conditions; 2 years if holding a master's degree
• Working knowledge of word processing, spreadsheet, database, and presentation software
• Understanding of insurance and benefit programs related to health management coverage
• Knowledge of the quality improvement process and national case management standards
• Ability to work independently, prioritize effectively, make sound decisions, and exercise good judgment
• Customer service, organizational, presentation, spelling, punctuation, and grammar skills
• Ability to persuade, negotiate, or influence others
• Analytical or critical thinking skills
• Ability to handle confidential or sensitive information discreetly
• Ability to drive and be available on nights and weekends
• Familiarity with evidence-based assessments
• Proficiency with Microsoft Office
• If RN: active, unrestricted U.S. and state-of-hire RN license, or active compact multistate unrestricted RN license
• If LPN: active, unrestricted U.S. and state-of-hire LPN license, or active compact multistate unrestricted LPN license
• If Social Worker: active, unrestricted LBSW, LMSW, or LISW license from the United States and state of hire or with a state compact
• For Mental Health Professionals: active, unrestricted LPC, LMFT, LAC, LPES, or Licensed Psychologist license from the United States and state of hire or with a state compact
• Preferred: experience working directly with individuals with mental illnesses
• Must reside in the Low-Country Region of South Carolina, preferably Beaufort County
• Must work Monday-Friday, 8:30am-5:00pm EST, 40 hours per week
• In-person member contact and regional travel required, with a travel limit of 3 hours one way

Benefits:

• Mileage reimbursement after mile 50 at a reimbursement rate of 70 cents per mile
• Subsidized health plans
• Dental and vision coverage
• 401k retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more
• Reasonable accommodations for disabilities, pregnancy-related conditions, and sincerely held religious beliefs