Behavioral Health Care Manager

MetroPlusHealth; New York (NY); On-site; USD 75,000 - 110,000; Full time

Job summary

MetroPlusHealth is seeking a Behavioral Health Care Manager to develop, facilitate, and communicate a plan of care in partnership with members, their Health Home, and care team. The role involves assessing behavioral health needs, coordinating services across settings, and advocating for appropriate resources.

You will meet members in homes or community settings, conduct ongoing assessments, and document care plans ensuring regulatory compliance.

Qualifications

• Master’s Degree in healthcare or related field required.
• 3-5 years of Behavioral Health experience, preferably in a Psychiatric Hospital Inpatient and/or Outpatient setting.
• 1-3 years of Behavioral Health Managed Care Case Management experience.
• Working knowledge of NY State Health Home System and Plan of Care process.
• Case Management Experience within the Integrated Collaborative Care Model Approach.
• Home visits to members and bedside assessments in inpatient or residential settings.
• Knowledge of Psyckes, E-Paces, HCS (UAS) MAPP; Microsoft Teams video knowledge preferred.
• Medical background and bilingual abilities preferred.
• Quality Management liaison experience with hospitals and large volume providers.

Responsibilities

• Clinically assess members for acute behavioral and physical health needs and generate referrals.
• Meet with members in homes, shelters, and community settings.
• Conduct initial and ongoing Behavioral Health assessments.
• Develop formal plans of care for all needed services.
• Notify physicians of changes and coordinate with nurses for updates.
• Document care coordination notes across internal and external providers.
• Attend ICT meetings and assist with coordinating services across settings.
• Support discharge planning and continuity of care across the continuum.
• Promote quality of care and outcomes for MetroPlusHealth members.
• Assist providers with pay-for-performance goals and value-based payment discussions.

Skills

Behavioral health

Assessment skills

Interpersonal skills

Home visits

Regulatory knowledge

Education

Master's degree in healthcare

Tools

DCMS

Microsoft Teams

Teams Video

Job description

Empower. Unite. Care.

MetroPlus

Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

About NYC Health + Hospitals

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.

Position Overview

The Behavioral Health Care Manager develops, facilitates, and communicates a plan of care in partnership with the member, their assigned Health Home, primary caregiver, the primary and attending physicians, and various Behavioral Health and/or Substance Use Disorder providers. This position collaborates with the aforementioned parties to assess, plan, facilitate, and advocate for options and services to meet a member’s behavioral health needs through communication and available resources.

Work Shifts

9:00 AM - 5:00 PM

Duties & Responsibilities

• Clinically assess members for acute behavioral and physical health needs. Generating referrals to providers, community-based resources, and appropriate services and other resources to assist in goal achievement.
• Expected to meet with members in their homes, shelters, other residential settings, at community agencies, hospital inpatient units and/or day hospital programs.
• Conduct initial and ongoing Behavioral Health clinical assessments.
• Develop a formal plan of care for all services needed for the member.
• Notify physicians for any changes in member's plan of care. Follow up with assigned nurses for clinical updates to plans of care.
• Document IDT care coordination notes between both internal MetroPlusHealth staff and external BH providers and caregivers.
• Attend and prepare for bi-Weekly Interdisciplinary Care Team (ICT) meetings which will feature newly enrolled, frequently admitted, high utilizing at risk members.Assist members with the coordination of services from various settings as appropriate. Including facilitating discharge from acute setting and alternate settings. Provides Care Coordination throughout the continuum of care.
• Optimizes both the quality of care and the quality of life for the MetroPlusHealth members.
• Assist providers with achieving pay for performance goals and examine the feasibility of Value Based Payment with high volume providers for Mainstream Medicaid.
• Educate providers on medication and treatment compliance while also promoting the use of Long Acting Injectables.
• Enlist existing provider network in promoting first episode psychosis treatment.
• Documents in a comprehensive manner to ensure that all goals, interventions, and care coordination activities for each member in DCMS system, and other applicable software programs, are complaint with professional standards and regulatory guidelines.
• Evaluate housing needs appropriately and assist with housing application process. Collaborating timely with MetroPlusHeatlh internal housing team for supportive assistance.
• Contributes to MetroPlusHealth corporate goals through ongoing execution of member care plans and member goal achievement.
• Performs other appropriate Behavioral Health Departmental duties and participates in other special projects as assigned, including, but not limited to, audit review and preparation, quality improvement, community health education, facility/provider relations and marketing activities.

Minimum Qualifications

• Master’s Degree in healthcare or related field required
• 3-5 years of Behavioral Health (Serious Mental Illness & Substance Use Disorder) experience, preferably in a Psychiatric Hospital Inpatient and/or Outpatient experience; and
• 1-3 years of Behavioral Health Managed Care Case Management experience
• Working knowledge of NY State Health Home System and Plan of Care process
• Case Management Experience within the Integrated Collaborative Care Model Approach
• Previous history of conducting home visits to members as well as assessing them bedside during an inpatient hospitalization or at their long-term Substance Abuse Residential setting.
• Knowledge of Psyckes, E-Paces, HCS (UAS) MAPP, Microsoft Teams Video knowledge preferred.
• Medical Background & Bilingual preferred.
• Previous Quality Management liaison experience with hospitals and other large volume providers to address cost. as well as HEDIS/QARR quality performance, preferred.

Licensure And/or Certification Required

• A valid license and current registration to practice as a Licensed Mental Health Counselor (LMHC), Licensed Marriage and Family Therapist (LMFT), Licensed Master Social Worker (LMSW), or Licensed Clinical Social Worker (LCSW) issued by the New York State Education Department (NYSED) is required.
• If in addition to one of the above licenses, a valid Credentialed Alcoholism and Substance Abuse Counselor (CASAC) Level I, Level II, Advanced, or Master issued by the NYS Office of Addiction Services and Supports (OASAS) is preferred.

Professional Competencies

• Integrity and Trust
• Customer Service Member FIRST Focus
• Superior Technical Computer skills (Microsoft Office, DCMS, Teams Video Application)
• Exceptional Organizational and Communication Skills
• Strong interpersonal and assessment skills, the ability to remain calm and poised with challenging members who often present as in a constant state of crisis.

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