Current Job Openings >> Behavioral Health Transitional Case Manager
Behavioral Health Transitional Case Manager
Summary
Title:Behavioral Health Transitional Case Manager
ID:VBP02
Location:Buffalo
Job Type:Full-time
Date Posted:05/21/2021
Openings:1
Department:VBP Clinical Management
Description
Want to be a part of an amazing organization? An organization that makes a difference in the lives of individuals each and every day?

Monroe Plan for Medical Care is a not-for-profit health care services organization that has been meeting the needs of our members in the Greater Buffalo, Rochester, Syracuse, and Binghamton Regions for nearly 50 years. Monroe Plan provides health home services and other critical health care services to individuals covered by Medicaid, Child Health Plus and the Essential Plan.

Following our mission and vision to improve the health status of individuals and families, Monroe Plan's innovative clinical care management programs are structured to meet the unique needs of members, providers, health care organizations and the communities we serve. Monroe Plan has consistently been recognized as a national leader in the "safety net" area, with a proven track record of improving health outcomes and reducing disparities by supporting a health care delivery system that ensures the availability of high quality medical care for all.

LCSW - Behavioral Health Transitional Case Manager
Grade 307

POSITION SUMMARY

Under the direction of the Manager, this position will provide telehealth behavioral health transitional care services to members. Transitional care services will be provided to identified members discharged from an inpatient behavioral health facility, following an emergency room discharge for either a mental health or substance use disorder diagnosis or for children newly prescribed ADHD medication. The Case Manager would provide identified practitioners with the findings of the telehealth visit(s) in an effort to reduce gaps in care and to ultimately improve QARR metric requirements. This position works with substantial independence in the field, with consultation available from other clinical staff and/or Manager, as needed.
 

ESSENTIAL JOB DUTIES/FUNCTIONS

 

 

% of Time

 

Essential Function






50%

Provides Telehealth Behavioral Health Transitional Care Services. Under the direction of the Manager, Clinical Performance & Network Relations, the Behavioral Health Transitional Case Manager will provide follow up to the following identified members:

- Members discharged after 7 days of inpatient hospital care for a diagnosed mental illness;
- Members discharged after 7 days from emergency room for a mental health diagnosis;
- Members discharged after 7 days from the emergency room for alcohol or other drug dependence;
- Child members newly prescribed ADHD medication and in maintenance phase.
- Meet regulatory and agency policy and procedures related to the practice and documentation of transitional care case management activities
- Demonstrate strong interpersonal skills in order to handle difficult situations in a professional and courteous manner
- Handles confidential information in accordance with HIPPA, state and federal confidentiality rules



20%

Consultation

- Collaborate with identified providers on the findings of the telehealth visit(s) for the coordination of needed care and services

 



20%

Documentation and Billing

- Document all telehealth transitional visits within Case Trakker
- All documentation should meet regulatory compliance and address errors/omissions to ensure billing is accurate and concise

 



10%

Collaboration with Care & Case Management Staff

- As time permits, collaborate with other members of the Case Management team to provide information and support for members in addressing barriers to health. Examples of consultative areas include but are not limited to benefit assessment and linkage, psychosocial assessments and linkage and assisting and advocating for staff, members and families with community resources and planning case conferences
- Will provide education regarding Health Home Care Management and link to Monroe Plan CMA as a referral source

 

Total must equal 100% - essential functions should be completed at least 10% of the time

 

OTHER FUNCTIONS AND RESPONSIBILITIES
- Identifies opportunities to improve processes and services. Shares with Manager issues that are obstacles to providing great service
- Performs other duties as assigned

 

MINIMUM REQUIREMENTS/LICENSES/CERTIFICATIONS
Licensed Clinical Social Worker
5 years behavioral health experience
- 3-5 years experience in a hospital or community-based setting
- Ability to be credentialed by Molina to its provider panel
- Effective and diplomatic oral communication skills. Good listening skills
- Sound reasoning and problem-solving skills
- Strong computer skills
- Ability to read, understand and follow written policies and procedures
- Able to work effectively with a multidisciplinary team
- Ability to learn new skills
- Ability to interact with individuals with diverse cultural and religious customs
 
PREFERRED QUALIFICATIONS
 
- Experience in insurance industry. Managed Medicaid experience a plus
- Experience in Case Management delivery

 

 

PHI MINIMUM NECESSARY USE: This staff position PHI access will be determined based on Minimum Necessary standards. The Minimum Necessary Grid can be found on the Human Resources and Compliance Web pages.

 

This job description is only a summary of the typical functions of the job, not an exhaustive or comprehensive list of all possible job responsibilities, tasks and duties. Additional responsibilities, tasks and duties may be assigned as necessary.

Monroe Plan for Medical Care is an Equal Opportunity Employer.

 

 

 

This opening is closed and is no longer accepting applications
ApplicantStack powered by Swipeclock