Specialty Care Manager, Behavioral Health (Boston area)
We’re seeking Specialty Care Managers to join our behavioral health team! In this role, you will work to promote the well-being of our members by assessing, collaborating with providers, monitoring and coordinating care.
Be a part of a mission driven company and work alongside passionate, caring and collaborative team members. If you are motivated to make a difference in people’s lives and want to play a role in transforming how healthcare is delivered, we invite you to check out the opportunity below and apply today.
Position will be telework, and will require travel to visit our members in person.
The Specialty Care Manager provides intensive care management, high-risk care management, and community-based care management for BMCHP members receiving behavioral health (BH) services. The Specialty Care Manager works alongside medical Utilization Management and medical Care Management staff, pharmacists, and medical directors as part of an integrated team and. follows members through the health care continuum, including acting as the liaison for hospital staff, PCPs, and other healthcare team members in facility discharge planning.
– Performs a variety of diverse and complex telephonic and face-to-face care management responsibilities and ensures that all service needs are met through monitoring of treatment plans, crisis plans, and inter-agency collaboration.
– Manage and carry out all activities of the intensive Care Management Program. This includes accepting referrals, identifying appropriate care management candidates, ensuring that all their service needs are met, and tracking their progress.
– Develop and implement treatment plans to assist members to develop the skills needed to successfully live and work as independently in the community as they are able.
– Utilizes technique such as Motivational Interviewing, Harm Reduction, Trauma Informed Care principles, Stages of Change and evidence-based practices to move the member towards readiness to engage in services, medication compliance, etc.
– Delivers high-risk care management services. As needed identifies service delivery gaps and barriers, ensures appropriate evaluation, service planning, and service delivery, and monitor care plan implementation and progress.
– Outreaches to members for medication monitoring and to encourage them to comply with medication regimens. Educates members as needed regarding the role and use of medications in their recovery.
– Works closely with families as appropriate, and includes members and their families in service planning.
– Works closely with state agency case management staff, particularly the Department of Mental Health.
– In all activities works to ensure linkage and integration of behavioral health and medical care. This includes both member-based activities and work with agencies as part of community-based care management.
– Documents clinical assessments and coordination of care in the medical management information system in a timely manner that meets regulatory and accreditation standards.
– After-hours availability as needed.
– Performs other duties as assigned.
– Degree in a behavioral health field such as psychology or social work or a degree in nursing required.
– Current certificate or state licensure as an RN, LICSW, LMHC, Clinical Nurse Specialist, Licensed Psychologist or CADAC is required.
– Two or more years related experience in Mental Health, BH Case Management, and/or substance abuse treatment.
– Experience with Medicaid recipients and community services.
– Experience with care management.
– Experience in a health plan or insurance environment.