Behavioral Health Case Manager - QMHP - Oregon Portland, OR

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

Job summary

An innovative non-profit consulting firm is seeking a dedicated Behavioral Health Case Manager to join their mission of transforming healthcare. In this role, you will conduct assessments, provide advocacy, and collaborate with various stakeholders to ensure individuals with serious mental illness receive the necessary support. With a focus on patient-centered service planning, you will play a crucial role in improving the quality of care and facilitating access to essential services. If you are passionate about making a difference in the lives of others and thrive in a dynamic environment, this opportunity is for you.

Qualifications

• QMHP License and 2 years of experience with individuals with SPMI required.
• Ability to conduct behavioral health assessments and develop treatment plans.

Responsibilities

• Conduct face-to-face assessments to create and maintain tailored PCSP.
• Advocate for individuals regarding service planning and coordination.
• Work with providers and community organizations to access appropriate care.

Skills

Behavioral Health Assessment

Clinical Review Criteria

Patient-Centered Service Planning

Mental Status Examination

DSM 5 Diagnoses

Treatment Plan Development

Education

QMHP License

2 years of experience with SPMI

Job description

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 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 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 years 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.