This position is responsible for the assessment, reassessment, care planning and coordination of care and services for Members enrolled in the case management program. Includes ongoing monitoring of an appropriate and effective person centered care plan, member education and care coordination. Regularly communicates with the member's PCP and other providers, and integrates the member, caregiver and other provider feedback into the assessment and planning.
Maintains a caseload of members enrolled in the case management program, including risk stratification of members, monitoring reassessment needs and facilitating transitions of care settings.
Serves as the primary point of contact throughout the treatment episode at the levels of care.
Coordinates with the interdisciplinary team of providers, vendors, facilities, discharge planners, nurses, social workers, care coordinators, and member/caregivers to effectively manage care plans and transitions of care settings.
Maintains timely, complete and accurate documentation in compliance with regulatory policies and procedures.
Participates in complex case rounds and/or meetings and consults with Physician Adviser/Medical Director on regular basis concerning the progress of members.
Provides consultation to PCP/Providers as indicated with consent of client. Identifies barriers to accessing services and assists members as needed.
Participate actively in the Quality Improvement program.
Other duties as assigned.
Other Job Requirements
Responsibilities
One or more of the following licensure is required: LCSW, LMFT, LPCC or RN.Proficient computer skills, including ability to converse and type at a conversational pace.Solid understanding of behavioral health diagnoses.Strong organization, time management and verbal and written communication skills.Knowledge and experience in working with case management and in facilities, with local care coordinators or with special populations.Knowledge of DSM V or most current diagnostic edition.
General Job Information
Title
Behavioral Health Case Manager -Licensed in CA (BH or RN) - Remote
Grade
23
Work Experience - Required
Behavioral Health, Case Management, Clinical
Work Experience - Preferred
Education - Required
Associates - Nursing, Masters - Behavioral Health
Education - Preferred
License and Certifications - Required
Current licensure required for this position that meets State, Commonwealth or customer-specific requirements - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LPCC - Licensed Professional Clinical Counselor - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt
License and Certifications - Preferred
CCM - Certified Case Manager - Care Mgmt
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.
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