Care Manager

Horizon Health And Wellness Oracle , AZ 85623

Posted 2 weeks ago

The Care Managers main purpose is to ensure their client caseload is provided with the necessary services they need, in a coordinated and effective manner. Responsible for the delivery of care management, advocacy and clinical services to the Seriously Mentally Ill and the Mental Health participants.

Responsibilities

  • Monitor the delivery of medically necessary services and progress toward goals and objectives.
  • Provides and/or ensures delivery of behavioral health services every 60 days to enrolled participants.
  • Coordinate and monitor service delivery by Specialty Providers to ensure medically necessary services are being delivered.
  • Ensure annual behavioral health assessments and service plan are updated at least annually and when there is a significant change.
  • Utilize and manage the Healthcare Effectiveness Data and Information Set (HEDIS) measures to ensure positive outcomes for participant care.
  • Utilizes the Care Report to manage the preventative care (HEDIS Measures) for the participants assigned to him / her.
  • Ensures delivery of behavioral health services after an ER visit or hospitalization to prevent readmission.
  • Responsible for utilization of proper community resources and referrals.
  • Assessing client needs by completing a thorough intake process.
  • Completion of necessary client/program documentation and billing in a timely manner.
  • Complete coordination of care meetings/staffing with specialty providers to monitor progress on goals.
  • Ensure integrity of programs clinical standards, practices and functions.
  • Provide consultation, education and advocacy services to families and other providers.
  • Follow up when care management responsibilities are transferred whether temporary or permanently.
  • Provide telephone contacts, collateral visits and non-medically necessary transportation.
  • Arrange referrals, assessing medical necessity and obtaining entitlements and meeting basic participant needs.
  • Participation in in-service/educational training as required and recommended by supervisor.
  • Perform other duties as assigned.

Requirements

Qualifications Required

  • HS diploma or GED plus 4 years experience in BH work; or combined BH education and experience totaling 4 years..
  • Must be at least 21 years of age or older.
  • Possess valid drivers license with acceptable driving record, telephone and reliable transportation.
  • Prior experience in the behavioral health setting.
  • Attend clinical staffing at treatment centers and psychiatric hospitals.
  • Carries caseload including individual and group counseling.
  • Certification in first aid, CPR and CPI.
  • Must be knowledgeable of benefit and entitlements process and community resources available.
  • Willing to work nights and weekends as needed.
  • Ability to effectively use CPI and behavior management techniques in crisis situations.
  • Demonstrates ability to distinguish between alcohol and other drug-related symptoms and other pre-existing physical problems or pathologic behaviors.
  • Demonstrates knowledge of how the acute and chronic nature of the chemical/co-dependence, and the ways medical, emotional, behavioral, social, educations, and other interventions are used to treat the participant.
  • Ability to type and working knowledge/familiarity with computers and electronic clinical record keeping.

Benefits

Gererous Beneift Package

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Care Manager

Horizon Health And Wellness