Behavioral Health Case Management Liaison SMI Population (Remote Available)
Company: Ohana Health Plan
Posted on: November 18, 2021
Position Purpose: Manages members with severe mental illness who
have high rates of behavioral health utilization and/or severe
psychosocial vulnerability. Acts as provider liaison to oversee the
Community Based Case Management (CBCM) Agencies who deliver and
coordinate the behavioral services of the CCS contract. Monitors
CCS contract compliance of the CBCM Agencies by collecting clinical
data and maintaining accurate records for tracking and metric
purposes. Candidate Education: * Required A Master's Degree in
Social Work, Psychology, Counseling, Rehabilitation, or other
relevant field that provides a foundation to receive a license as
required of the position Candidate Experience: * Required 2+ years
of experience in behavioral health management and/or acute
behavioral health care setting focusing on outpatient/inpatient
utilization, case management and discharge planning
Essential Functions: * Manages members with severe mental illness
who have high rates of behavioral health utilization and/or severe
* Acts as provider liaison to oversee the Community Based Case
Management (CBCM) Agencies who deliver and coordinate the
behavioral services of the CCS contract.
* Identification and tracking of all assigned members of assigned
* Audits member records for compliance of CCS contract.
* Collects clinical data and maintains accurate records for
tracking and metric purposes.
* Oversees CCS contract compliance of the CBCM agencies (i.e.
Behavioral Health Assessment (BHA)/Individualized Treatment Plan
(ITP) received within specified timeframes, quarterly BHS reports,
post hospitalization follow up, etc.).
* Maintains ongoing contact with assigned CBCM agencies.
Participates in agency educational meetings and agency visits.
* Facilitates enrollment and eligibility changes.
* Performs other duties as assigned. Additional Responsibilities: *
Notifies CBCM Agency when a member is admitted for a Behavioral
Health Inpatient Hospitalization.
* Reviews authorization requests for CCS program benefits.
* Serves as Officer of the Day (OOD) to address calls from customer
service and internal -Ohana staff.
* Processes Adverse Events.
* Coordinates with member 's QUEST Integration Health Plan Service
Coordinator for continuity of care.
* Holds Interdisciplinary Team (IDT) Meetings for complex,
high-risk, high-utilizing members and participates in departmental
clinical rounds.* Required 1+ year of experience in current case
management as a licensed professional
* Required Other Experience working with the needs of vulnerable
populations who have chronic or complex bio-psychosocial needs
* Preferred Other Experience in a managed care environment Licenses
and Certifications:A license in one of the following is required:
Required Other A master's level independent or non-independent
license is required OR an RN with a behavioral health
Required Licensed Registered Nurse (RN)
Required Licensed Clinical Social Worker (LCSW)
Required Licensed Clinical Mental Health Counselor (LCMHC)
Required Licensed Psychologist
Required Licensed Clinical Marriage & Family Therapist (LCMFT)
Required Licensed Clinical Psychologist (LCP)
Required Acute Care Nurse Practitioner (APRN) (ACNP-BC)
Centene is an equal opportunity employer that is committed to
diversity, and values the ways in which we are different. All
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability, veteran status, or
other characteristic protected by applicable law.
Keywords: Ohana Health Plan, Honolulu , Behavioral Health Case Management Liaison SMI Population (Remote Available), Executive , Aiea, Hawaii
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