Clinical Care Manager II (full-time)

Clinical Care Manager II - Idaho

General Position Summary :

• This full-time position is responsible for providing utilization review activities and clinical peer reviews for all levels of behavioral health care;
• clinical assessment, placement and continued stay reviews; completing mental health reviews and determining need for further assessment;
• collecting and analyzing utilization data; intensive case management. This position also assists with answering crisis phone calls;

provides customer support to clients, providers and stakeholders; and participates in quality improvement projects.

Essential Functions :

Conduct clinical assessments.

Conduct clinical placement and continued stay reviews.

Conduct clinical peer reviews.

Coordinate community based mental health assessments.

Provide Intensive Case Management services as assigned.

Crisis phone call response.

Secondary Functions :

Communicate and advise clients, provider network, and stakeholders regarding behavioral health benefits, utilization management function, community treatment resources, and BPA Health policies, procedures, and criteria.

Participate in quality improvement activities, including peer audits and data collection, tracking and analysis.

Advocate for the client to ensure treatment needs are met. Propose alternative plans of treatment when requests for services do not meet medical necessity criteria.

Provide appropriate referrals as needed.

Perform other duties as assigned.

Supervisory Responsibility :

None

Education and / or Experience :

Master's degree in behavioral health field (i.e., counseling, social work)

Unrestricted Idaho clinical licensure in behavioral health (LPC, LCPC, LCSW or LMFT required)

Proficient with MS Office, including Word, Excel, PowerPoint and Outlook.

Pass a criminal history background check and drug screen.

Specific Job Skills and Competencies :

Excellent customer service skills.

Strong interpersonal, oral and written communication, organizational, analytical, time management, and computer skills.

Knowledge of utilization management procedures and behavioral health community resources and providers.

Crisis intervention skills.

Ability to exercise sound judgment, make logical decisions and to perform independently and as a team member.

Knowledge of DSM 5 and ASAM criteria.

Ability to audit clinical review criteria, analyzes specific utilization problems, plan and implement solutions that directly influence quality of care.

Strong initiative and creative problem-solving abilities.

Appreciation of cultural diversity and strong sensitivity towards target member population.

Detail oriented and accurate with the ability to manage multiple projects at one time.

Adherence to the values and mission of BPA Health

Must be reliable, punctual, and flexible.

Travel Requirements :

Limited travel, up to 10% may be required. Ability to make trips involving overnight stays. Means of transportation required.

Physical Requirements :

While performing the duties of this job, the employee is continuously required to read, talk and hear. The employee is continuously required to walk, sit or stand at a computer workstation, use hand to finger, handle or feel objects, tools, or controls;

and reach with hands and arms. The employee frequently lifts and / or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

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