Case Manager, Behavioral Health, Licensed Clinician

ZipRecruiter; French Camp (CA); Remote; USD 60,000 - 100,000; Full time

Job summary

Join a forward-thinking organization as a Behavioral Health Case Manager, where you will play a vital role in supporting individuals facing complex health challenges. This remote position allows you to leverage your clinical expertise to assess psychosocial factors, develop care plans, and coordinate resources for members. You'll collaborate with diverse teams to ensure quality care that aligns with regulatory standards. If you're passionate about making a difference in the lives of others and thrive in a dynamic environment, this opportunity is perfect for you. Embrace the chance to grow professionally while contributing to a compassionate mission.

Qualifications

• 3+ years as a social worker in a healthcare setting.
• Licensed as LCSW, MFT, or LPCC.

Responsibilities

• Conduct initial reviews and triage for selected members.
• Develop care plans in partnership with members and providers.

Skills

Psychosocial Assessment

Clinical Judgment

Problem-Solving

Communication Skills

Time Management

Negotiation Skills

Education

Licensed Clinical Social Worker (LCSW)

Marriage and Family Therapist (MFT)

Professional Clinical Counselor (LPCC)

Tools

Microsoft Word

Microsoft Excel

Job description

Job Description

The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

We are currently hiring a Case Manager, Behavioral Health, Licensed Clinician to join our team.

Must reside in California - remote position.

Summary

Under general direction, the Behavioral Health Case Manager, Licensed Clinician is responsible for providing intervention services to assist members and their families in coping with complex social problems that accompany medical and behavioral health conditions or inhibit recovery in a manner that supports quality, cost-effective care, and is consistent with department objectives and applicable regulations. Work is varied and moderately complex and requires a moderate degree of discretion and independent judgment.

Supervises

• None

Essential Functions

1. Conducts initial review for selected members, triages as appropriate.
2. Assesses psychosocial factors that may influence health or recovery for identified members.
3. Develops care plans in partnership with members, their provider, and plan staff.
4. Collaborates with members, family/caregiver, and internal and external resources to ensure understanding of and compliance with care plans.
5. Provides and coordinates resource contacts, and/or referrals to appropriate professional or community resources.
6. Monitors and evaluates progress at appropriate intervals; conducts appropriate interventions.
7. Assists RN case managers and concurrent review nurses with case management, discharge planning and other member transition needs.
8. Assists CM & CCRN in assessing members for Mental Health/Behavioral needs and refers to appropriate resources to meet needs.
9. Performs community outreach for selected members as assigned.
10. Supports and advises member on self-advocacy efforts.
11. Documents activities in appropriate plan system(s) according to standards; maintains records according to standards.
12. Tracks data as required; compiles data for, produces and submits routine reports.

Non-Essential Functions

• Other duties as required.

Knowledge, Skills, Abilities and Competencies

Required

• Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines.
• Ability to apply clinical judgment to complex medical situations and make timely decisions.
• Strong psychosocial assessment skills.
• Strong knowledge of prevention, treatment and rehabilitation techniques used in the identification and treatment of mental illness and emotional disorders.
• Strong knowledge of federal, state and local laws, rules and regulations associated with mental health treatment and education programs.
• In-depth understanding of the treatment of mental illness, including wellness and recovery as well as strength-based approaches for individuals and their families.
• In-depth knowledge of chronic and acute disease and how they impact health conditions and social functioning.
• Strong knowledge of and proficient skills in administering protocols.
• In-depth knowledge of community resources related to healthcare.
• In-depth knowledge of medical policy benefits and exclusions.
• Ability to read, interpret and apply complex written regulations, guidelines and other materials; ability to read and interpret basic clinical information.
• Strong analytical and assessment skills.
• Strong problem-solving skills.
• Basic negotiation skills.
• Produces work that is accurate and complete.
• Produces the appropriate amount of work.
• Actively learns through experimentation when tackling new problems, using both successes and failures to learn.
• Rebounds from setbacks and adversity when facing difficult situations.
• Knows the most effective and efficient process to get things done, with a focus on continuous improvement.
• Interpersonal skills - interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.
• Ability to use tact and diplomacy to diffuse emotional situations.
• Strong oral and written communication skills, with the ability to communicate professionally to diverse individuals inside and outside of HPSJ, effectively explain complex information and document according to standards.
• Strong customer service skills.
• Ability to work independently and as part of a team.
• Time management and organizational skills. Uses time effectively and efficiently. Values time. Concentrates efforts on priorities. Can attend to a broad range of activities. Meets deadlines.
• Basic skills in Word and Excel.
• Ability to enter data into and navigate through multiple databases.
• Ability to speak and be understood in English.
• Ability to handle confidential information with appropriate discretion.

Preferred

• Proficient in one of HPSJ’s threshold languages.
• Basic knowledge of principles, practices and regulatory requirements of managed care.
• Knowledge of Medi-Cal or other government-sponsored programs and regulations as they apply to social work.

Education and Experience

Required

• Licensed Clinical Social Worker (LCSW), Marriage and Family Therapist (MFT), or Professional Clinical Counselor (LPCC) license.
• At least three years as a social worker in a healthcare setting.

• Experience working with Medi-Cal and other government-sponsored programs.
• Experience in managed care setting.

Licenses, Certifications

Required

• Current Clinical Social Worker (LCSW), Marriage and Family Therapist (MFT), or Licensed Professional Clinical Counselor (LPCC) license issued by the California State Board of Behavioral Science Examiners.
• Valid California driver license and reliable transportation, or the ability to obtain transportation in the counties served by the plan if prohibited from getting a driver license due to a medical condition.

We are an equal opportunity employer and value diversity. We believe that including individuals of various characteristics helps us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are based on qualifications and merit.

HPSJ provides equal employment opportunities and prohibits discrimination based on race, color, religion, sex, gender identity, sexual orientation, marital status, registered domestic partner status, age, disability, genetic information, military or veteran status, political affiliation, or any other characteristic protected by law. Discrimination based on perception or association is also prohibited.

Important Notice: This job description is not a contract. Duties may change at HPSJ's discretion, and employees may be asked to perform duties not listed here.