Remote Behavioral Health Case Manager - Massachusetts only

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care.

Job Summary:

The Case Manager -Behavioral Health collaborates with members of an inter-disciplinary care team (ICT) to meet the needs of members admitted to behavioral health facilities or receiving behavioral health services including inpatient psychiatric hospitals, detox facilities and Clinical Stabilization Services (CSS). The Case Manager interfaces with members of the patient's care team to coordinate discharge planning, ensuring that the member has appropriate follow up care.

Essential Functions:

• Engage the member and complete a health and psychosocial survey, taking into account the cultural and linguistic needs of each member
• Engage with the member to establish an effective, professional relationship via telephonic or electronic communication
• Participate in development of an individualized care plan (ICP) in collaboration with Behavioral Health facility staff and ICT staff to identify and coordinate care plans and discharge plans tailored to the individual member's needs.
• Identify and manage barriers to achievement of care plan goals
• Identify and implement effective interventions based on opportunities identified in members plan of care
• Maintain a comprehensive knowledge base of benefits, network diversionary care programs, network outpatient providers and resources within the referral community for discharge planning and placement
• Assist with empowering the member to manage and improve their health, wellness, safety, adaptation, and self-care through effective care coordination and case management
• Coordinate, communicate and collaborate with the member and the ICT in order to achieve goals and maximize positive member outcomes
• Educate the member/caregivers about risk conditions, community resources, insurance benefits, etc. so that timely and informed decisions can be made
• Evaluate member satisfaction through open communication and monitoring of concerns or issues
• Coordinate with community-based case managers and other service providers to ensure coordination of behavioral health services and avoid duplication of services
• Document care coordination activities and member response in a timely manner according to standards of practice and policies regarding professional documentation
• Look for ways to improve the process to make the members experience with easier and shares with leadership to make it a standard, repeatable process
• Performs any other job related duties as requested.

Education and Experience:

• Bachelor's Degree in a healthcare related field required
• Equivalent years of relevant work experience may be accepted in lieu of required education
• One (1) year of experience working with individuals with behavioral health conditions in a case management/care coordination capacity required
• Three (3) years of experience in a healthcare field (i.e. discharge planning, case management, care coordination, and/or home/community health management experience) required

Competencies, Knowledge and Skills:

• Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel
• Ability to communicate effectively with a diverse group of individuals
• Ability to multi-task and work independently within a team environment
• Knowledge of local, state & federal healthcare laws and regulations & all company policies regarding case management practices
• Strong advocate for members at all levels of care
• Strong understanding and respect of all cultures and demographic diversity
• Ability to interpret and implement current research findings
• Awareness of community & state support resources
• Critical listening and thinking skills
• Decision making and problem solving skills
• Strong organizational and time management skills

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members and may refer members to other CareSource resources.
• Travel is not typically required

Compensation Range:
$54,500.00 - $87,300.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type:
Hourly

Competencies:
- Fostering a Collaborative Workplace Culture
- Cultivate Partnerships
- Develop Self and Others
- Drive Execution
- Influence Others
- Pursue Personal Excellence
- Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.