Behavioral Health Case Manager - QMHP - Oregon

Comagine Health; Portland (OR); Remote; USD 71,000 - 88,000; Full time

Job summary

An established industry player is seeking a dedicated Behavioral Health Case Manager to enhance the lives of individuals with severe mental illness. This role involves conducting assessments, advocating for patient-centered service planning, and collaborating with various stakeholders to ensure effective care delivery. The position offers the opportunity to make a significant impact in the community while working remotely with occasional travel. Ideal candidates will possess a QMHP license and experience in behavioral health, demonstrating a commitment to improving healthcare outcomes. Join a mission-driven team focused on transforming lives and healthcare systems.

Qualifications

• Ability to conduct behavioral health assessments and identify risks.
• Proficient in developing treatment and safety plans.

Responsibilities

• Conduct face-to-face assessments and maintain tailored PCSP.
• Advocate for individuals regarding service coordination and planning.

Skills

Behavioral Health Assessment

Patient-Centered Service Planning

Eligibility Determination

Clinical Review Criteria

Treatment Planning

Education

QMHP License

2 years of experience with SPMI

Job description

Behavioral Health Case Manager - QMHP - Oregon

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Category

Care Management

Job Location

Portland

Tracking Code

134770

Industry

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Job Level

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Position Type

Full-Time/Regular

Years of Experience

Not Applicable

Comagine Health is looking for a Behavioral Health Case Manager to work remotely, with regional travel to perform in-person assessments. There are two vacancies which may include work in Eastern Oregon or other parts of the state. Comagine Health partners with the Oregon Health Authority (OHA) to provide statewide eligibility determination, service coordination, medical appropriateness reviews, and transition planning for individuals diagnosed with serious and persistent mental illness (SPMI). Our goal is to support adults with SPMI to live in the least-restrictive settings possible by ensuring that necessary and desired supports and services are in place.

Who is the Comagine Health?

Comagine Health is a non-profit consulting firm that seeks to improve health and to increase the effectiveness and quality of health care. As a recognized Quality Improvement Organization (QIO), we support providers, plans, purchasers, and consumers, and offer services to state and federal agencies and others to help them better manage health care under the existing system and to assess, plan for and implement broader system transformation. We collaborate with academic, government, and nonprofit partners on initiatives funded by NIH, CDC, AHRQ, BJA, SAMHSA, and others. In short, we are changing healthcare at a fundamental level.

What you'll be doing for us:

• Conduct initial, annual, and as needed face-to-face assessments to create and maintain a tailored PCSP, utilizing LOCUS, the LSI, and review of records.


• Provide advocacy to individuals (and authorized representatives and supports) regarding assessment, patient-centered service planning, service coordination, and transition planning.


• Assist in eligibility determinations as needed.


• Work closely with individuals, providers, facilities, and social service and community organizations to assist individuals in accessing appropriate care.


• Ensure care is being delivered as described in the PCSP, working with providers and individuals to correct services or adjust the PCSP as needed.


• Perform prior authorizations for services.


• Apply clinical review criteria, guidelines, and screen to determine the medical necessity of health care services.


• Consult with physicians or practitioner consultants when reviews fail clinical review criteria, guidelines, and screens.


• Follow all determinations, appeals and hearings policies, processes, and contract requirements.

Ideally, candidates will reside in the Oregon , with travel of up to 50% throughout the region.

Competencies:

• Demonstrated ability to conduct a behavioral health assessment including the identification of precipitating events, including health and safety risks to self or others.


• Competent in gathering histories of mental and physical health, substance use, and criminal justice system.


• Ability to conduct a mental status examination.


• Competent in providing DSM 5 diagnoses.


• Proficient in developing treatment plans and safety plans.

Required Qualifications:

• QMHP License.


• 2 year's of experience working with individuals with severe and persistent mental illness.


• Candidates must reside in the geographic area and be willing to travel in their personal vehicle up to 50% of the time to perform in person assessments.

Desired Qualifications:

• Oregon Medicaid knowledge, and knowledge of Oregon Health Plan's Prioritized List of Health Services preferred.

Salary Range: $71,000 - $88,000

The salary range posted reflects the range that Comagine is willing to pay for this position. Salary is determined by many factors, including but not limited to geographic location of where the employee will perform their job duties in addition to their knowledge, skills, education, and relevant work experience.