Behavioral Health Care/Case Manager

Reference Number: EXkHqG
Location: Orlando, Florida, US

This position is responsible for performing behavioral health duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Performs duties and types of care management as assigned by management.

 

Plus but not required: Previous CM exp. or managed care exp.

Job Description:

  • Assesses patient's behavioral health clinical need against established guidelines and/or standards to ensure that the level of care and length of stay of the patient are medically appropriate for inpatient stay.
  • Evaluates the necessity, appropriateness and efficiency of behavioral health medical services and procedures provided.
  • Coordinates and assists in implementation of plan for members.
  • Coordinates the delivery of high quality, cost-effective care supported by clinical practice guidelines established by the plan addressing the entire continuum of care.
  • Monitors patient's behavioral health medical care activities, regardless of the site of service, and outcomes for appropriateness and effectiveness.
  • Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided.
  • Encourages member participation and compliance in the behavioral health case/disease management program efforts.
  • Documents accurately and comprehensively based on the standards of practice and current organization policies.
  • Interacts and communicates with multidisciplinary teams either telephonically and/or in person striving for continuity and efficiency as the member is managed along the continuum of care.
  • Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes.
  • Completes other assigned functions as requested by management.

Education

  • Bachelor Degree in Social Work, Psychology or Human Services related field

Skills and Abilities

  • Analytical
  • Compassion
  • Interpersonal & Client Relationship Skills
  • Judgment
  • Listening
  • Planning/Priority Setting
  • Problem Solving
  • Team Player
  • Time Management
  • Written/Oral Communication & Organizational Skills

 

 

Standard Management (Manager/Supervisor of Staff)
clear