Case Mgr Behavioral Health, ABA services - remote (PA / NJ / DE)

Bring your drive for excellence, team orientation and customer commitment to Independence Blue Cross; help us renew and reimagine our business and shape the future of health care. Our organization is looking to diversify, grow, innovate and serve, and we are looking for committed, empowered learning-oriented people to join our team. If this describes you, we want to speak with you.

At Independence, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

The Autism Case Management (ACM) Program Case Manager position functions as a primary clinical resource for members living with challenges related to Autism Spectrum Disorder related. The ACM Case Manager collaboratively engages members in strengths-based approaches to facilitate increased understanding of each member's behavioral and physical health needs. Through this process, members gain the skills and supports to facilitate lifestyle improvement thereby enabling a holistic, person-centered approach to addressing their overall health. The ACM Case Manager provides support, guidance, and education to help members and their families better cope with acute symptoms and make treatment decisions based on their individual preferences and needs.

The ACM Case Manager facilitates the development of a care plan tailored to address the member's identified strengths and needs. This also includes coordination and collaboration with the member's health care team to better enhance advocacy and communication around the delivery of high-quality, cost-effective services including ongoing screening, assessment, treatment planning, treatment delivery and monitoring of a member's mental and physical health conditions.

In order to maximize access to care, the ACM Case Manager teaches and guides members to better navigate the behavioral and physical health care systems, providing advocacy when needed.

Case Managers have a strong understanding of the behavioral change process and use motivational interviewing techniques and other interventions to help the member resolve any barriers to change thereby improving adherence to evidence-based, cost-effective treatment and services.

Key Responsibilities :

§ Telephonically engages members who have ASD to clinically address challenges and identify barriers to care.

§ Engages with members, and their family where applicable, to identify strengths, needs and goals, in order to facilitate development of care plans. Provides follow-up when clinically appropriate and requested by the member.

§ Works with the BCBAs, Medical Directors and other team members to shape care planning and provision

§ Serves as a liaison and support, working within the member's health care team when needed especially when members are involved in complex behavioral health situations that often warrant changes to the member's care plan.

§ Identifies and provides coaching for members to access online, telephonic and community-based resources that can assist the member in achieving and maintaining their personal behavioral and physical health goals. In addition, assist in maximizing the use of member's benefits and ensuring coordination of services and outcomes.

§ Provides appropriate clinical assessment, intervention and support to members who actively seek behavioral health support via inbound calls.

Qualifications :

Active PA Registered Nurse (B.S.N. Preferred), LCSW, LSW, LMFT, LPC or BCBA required

Experience, Knowledge, & Skills :

• Minimum of 3-5 years post licensure experience in an integrated care setting, hospital or other health care setting.
• 3 years' experience working with children and / or adults with autism, experience providing case management or utilization management to members with autism spectrum disorder
• Knowledge of ASD, DSM-5 and ASAM
• Strong understanding of the Social Determinants of Health and Motivational Interviewing approaches to help member's move past barriers to improved behavioral and physical health outcomes.
• Ability to work independently using critical thinking to resolve complex behavioral, medical, and psychosocial issues with our members.
• Excellent assessment and engagement skills and ability to adapt clinical skills while using telephonic and virtual means.
• Embraces new ideas and methods; creates and acts on new opportunities; is flexible and adaptable.
• Ability to meet individual productivity goals in order to provide quality, cost-effective services and support to members.
• Exceptional problem-solving and organizational skills required.
• Works to build relationships and provides exceptional customer service.
• Able to work effectively as part of a team.
• Highly professional interpersonal skills.
• Excellent organizational planning and prioritizing skills.
• Strong computer skills and experience with Microsoft Office Suite.

Fully Remote :

This role is designated by Independence as fully remote. The incumbent will not be required to report to one of Independence's physical office locations to perform the work. However, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.