Horizon Health And Wellness
Oracle , AZ 85623
Posted 2 weeks ago
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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.
- 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.
- 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.
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