Case Mgr Behavioral Health (Triage) - Remote (PA/NJ/DE)

Independence Blue Cross; Philadelphia (Philadelphia County); À distance; USD 70 000 - 95 000; Plein temps

Avantages offerts par ce poste

Fully remote

Tri-State Area (DE/NJ/PA)

Résumé du poste

Independence Blue Cross is seeking a Behavioral Health Triage Case Manager to support at-risk members through crisis intervention, care navigation, and care coordination. You will collaborate with healthcare teams to plan and monitor services, advocate for patients, and connect them to timely behavioral health resources.

Qualified candidates hold an active PA RN license (BSN or related licensure preferred) and have 3–5 years of behavioral health clinical experience, including crisis intervention

Qualifications

• Active PA Registered Nurse License required.
• BSN or licensure in related field preferred.
• Experience in behavioral health clinical settings and crisis intervention.

Responsabilités

• Provides telephone triage and crisis intervention for at-risk members.
• Engages with members and families, assesses needs, provides information and navigation.
• Deescalates callers; provides brief supportive counseling in crises.
• Matches members with BH and substance-use providers based on needs.
• Incorporates lifestyle improvement and prevention opportunities into interactions.
• Contacts providers to facilitate care coordination.
• Identifies resources to maximize member benefits and care outcomes.

Connaissances

Crisis intervention

Telephone triage

Care coordination

Communication

Teamwork

Customer service

Microsoft Office

Formation

PA RN License

BSN or related licensure

Outils

Microsoft Office Suite

Description du poste

Shift

Mon.-Thurs. 12:15-8:30pm, Fri. 10:45a-7pm

Bring your drive for excellence, team orientation and customer commitment to Independence Blue Cross; help us renew and reimagine our business and shape the future of health care. Our organization is looking to diversify, grow, innovate and serve, and we are looking for committed, empowered learning-oriented people to join our team. If this describes you, we want to speak with you.

Job Summary

Behavioral Health Triage Case Manager position works with at- risk members to facilitate clinically appropriate linkages to care. Triage Case Managers collaborate on care plan development and coordination with members and members health care team including physicians by screening, assessing, planning, facilitating, monitoring and giving input when adjustment is needed, and advocating for the member on an individual basis. Case Managers use clinical and motivational interviewing skills to assess member’s need including crisis intervention to navigate and connect members to timely and effective services. Triage Case Managers work with the member to identify and address barriers to member’s adherence to standards of evidence -based medicine. The case manager facilitates communication between the patient, family, and members of the health care team while acting as an educator and link between the patient, providers and the plan, ensuring high quality, cost-effective services are delivered. Helps members coordinate care and navigate the healthcare system.

Key Responsibilities

• Provides telephone triage, crisis intervention and care navigation for at-risk members with mental health and/or substance use concerns


• Demonstrates the ability to engage with members, and families, effectively assessing needs; providing evidence informed information, resources, and navigation to promote accurate and timely access to appropriate behavioral health services


• Skillfully deescalates callers, provides brief supportive counseling and takes action in crisis situations. Manages high risk interactions to ensure the appropriate level of support and intervention is provided in an efficient manner.


• Matches members with appropriate behavioral health and substance use providers based on clinical assessment and access needs, follows processes to ensure members are connected to care


• Proactively incorporates lifestyle improvement and prevention opportunities into member interactions and coaching.


• Contacts members physician/health care provider when needed especially in more complex behavioral health situations requiring case management intervention to facilitate care coordination and potential care plan changes.


• Identifies on-line, telephonic and community- based resources that can assist the member in achieving and maintaining their personal health goals. Assist the member in accessing those services. In addition, assist in maximizing the use of member’s benefits and ensuring coordination of services and outcomes.

Qualifications

Qualifications - Internal

Education/Licensure

• Active PA Registered Nurse License required. B.S.N. or LSW, LCSW, LPC

Experience, Knowledge, & Skills

• Minimum of three to five years post licensure in behavioral health clinical experience in a hospital or other health care setting including training in crisis intervention and suicide prevention.


• Previous experience preferred in Utilization Review or Case Management, Care Navigation


• Knowledge of DSM 5 and ASAM


• Ability to work independently using critical thinking to resolve complex behavioral, medical, and psychosocial issues for our members.


• Ability to adapt clinical assessment skills to telephonic assessment and follow-up.


• Comfortable with new ideas and methods; creates and acts on new opportunities; is flexible and adaptable.


• Exceptional problem-solving and organizational skills required.


• Works to build relationships and provides exceptional customer service.


• Able to work effectively as part of a team.


• Highly professional interpersonal skills.


• Strong computer skills and experience with Microsoft Office Suite.

Fully Remote

This role is designated by Independence as fully remote. The incumbent will not be required to report to one of Independence’s physical office locations to perform the work. However, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

Independence Blue Cross is an Equal Opportunity and Affinity Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.