Job Description
Position Summary:
As an integral member of the care management team, the Behavioral Health (BH) Care Manager (CM) will have the opportunity to make a profound impact on the lives of individuals living with complex and/or chronic Behavioral Health conditions, many of whom also face multiple barriers in their lives which makes it difficult for them to achieve the self-care required to improve their health and well-being. This position requires flexibility, creativity, and may vary from day-to-day to meet members where they are. Outreach methods may vary and may include telephonic or in person in a variety of potential settings such as, but not limited to, the health center, community, home, or inpatient facility.
Essential Duties and Responsibilities:
* Conducts Comprehensive Clinical Assessments.
* Engages members and caregivers in active care planning with a focus on medical, behavioral, social, and member-centered care needs. Coaches and guides member/representative to meet bio/psycho/social care goals.
* Assess the member’s knowledge of their medical, behavioral health, and/or social conditions and provides education and self-management support based on the member’s needs and preferences.
* Work with the member to develop a self-management plan.
* Coordinate care with the member's providers, such as facilitating medication reconciliation with pharmacist, RN, and/or primary care team.
* Provide care coordination, which may include but is not limited to facilitating care transitions, supporting the completion of referrals, and/or providing or confirming appropriate follow-up.
* Manage treatment access and follow up with members with coexisting medical and behavioral disorders.
* Use motivational interviewing and coaching to help patients increase their motivation and commitment to changing their behavior and to strengthen their motivation for and movement toward a specific goal.
* Participates in the integrated care team meetings and rounds as required.
* Maintain accurate, timely documentation in electronic systems including health center Electronic Health Records (EHRs).
* Other duties as assigned.
Qualifications and Education Requirements:
Education and Experience:
Licensed Independent Social Worker (LICSW) or Licensed Mental Health Counselor (LMHC). Master’s Degree in Psychology, Social Work, or related field.
Minimum 2-5 years of experience providing patient-centered outreach, behavioral health services, needs assessment, and support.
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