BH Case Management Team Lead

Harris Health; Houston (TX); On-site; USD 70,000 - 90,000; Full time

Job summary

Community Health Choice, Inc. is seeking a Behavioral Health Case Management Team Lead to oversee CHC members with behavioral health needs.

You will coordinate daily operations, guide Coordinators and Case Managers, and partner with utilization management, member services and quality improvement to deliver high-quality care. Responsibilities include maintaining staff productivity, conducting audits, delivering training, leading monthly meetings, and driving program development and process

Qualifications

• Master's degree in Social Work or Counseling required.
• LMSW/LCSW/LPC/LMFT licensure required.
• CCM/ACM preferred.

Responsibilities

• Coordinate daily operational aspects of the team and assist management.
• Monitor workload distribution and productivity metrics.
• Lead staff training, audits and performance reviews.
• Hold monthly team meetings and document minutes.
• Drive program development and process improvements.

Skills

Team leadership

Case coordination

Staff mentoring

Quality audits

Education

Master's degree in Social Work or Counseling

LMSW, LCSW, LPC, LMFT licensed

CCM/ACM preferred

Tools

Microsoft Office

Job description

About Us

Community Health Choice, Inc. (Community) Is a Non-profit Managed Care Organization (MCO), Licensed By The Texas Department Of Insurance. Through Its Network Of More Than 10,000 Providers And 94 Hospitals, Community Serves Over 400,000 Members With The Following Programs

• ' Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
• ' Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
• ' Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
• ' Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Job Summary

The Behavioral Health Case Management Team Lead will manage CHC members with behavioral health diagnosis through comprehensive evaluation and through coordination of resources. The Behavioral Health Case Management Team Lead will participate as a team member in CHC Behavioral Health Department.

The Behavioral Health Case Management Team Lead will work collaboratively with utilization management, member services and the quality improvement departments.

JOB SPECIFICATIONS AND CORE COMPETENCIES

Coordinates daily operational aspects of team and assists manager with staff

Supervision

Monitors and facilitates equal distribution of workload assignments

Assists manager in setting productivity goals

Monitors Coordinators and Behavioral Health Case Managers to ensure performance and productivity metrics are met

Reviews and documents staff productivity on monthly and ad hoc basis

Informs manager about escalated issues and works with manager to resolve them

Monitors adherence to attendance, PTO, lunch, and break guidelines

Quality/Process Improvement

Complete quality audits by comparing productivity sheets to recorded calls and documentation in the system

Provides information for employee performance reviews.

Identifies training needs

Ensures that staff completes required training

Holds monthly team meetings with staff and documents minutes

Evaluations of team members and any necessary improvement plans

Completes documentation and call monitoring audits quarterly and ad hoc

Assists with new and ongoing employee training and development of training documents

Identifies opportunities for process and productivity improvement and shares with manager

Assist with the development of policy and procedures and job aides pertaining to the Behavioral Health Case Management Team

Coaches and mentors staff on issues identified

Assist With Program Management

Development and/or redesign of the Behavioral Case Management Program

Recommend improvements to the Behavioral Health Case Management Program

Development or redesign of program materials

Maintain And Report Required Program Analytic Requirements.

Complete special projects as assigned

Actively contributes to achievement of departmental goals, as identified in Departments annual business plan, including specific departmental process improvement plans

Other duties as assigned.

Qualifications

Education/Specialized Training/Licensure: Master's Degree in Social Work, Counseling required.

LMSW, LCSW, LPC, LMFT required.

CCM, ACM preferred.

Work Experience (Years and Area): Minimum of 4-years BH Case Management to include Minimum of 1 Year MCO experience

Software Proficiencies: Microsoft Office (Word, Outlook, Excel)