HonoluluRecruiter Since 2001
the smart solution for Honolulu jobs

Behavioral Health Case Management Liaison SMI Population (Remote Available)

Company: Ohana Health Plan
Location: Aiea
Posted on: November 18, 2021

Job Description:

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 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.
* Identification and tracking of all assigned members of assigned CBCM agencies.
* 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 background:
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)
Required Other

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

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Log In or Create An Account

Get the latest Hawaii jobs by following @recnetHI on Twitter!

Honolulu RSS job feeds