Clinical Care Manager, Behavioral Health
General Description
The Clinical Care Manager will develop individualized care planning, initiate, and coordinate interdisciplinary case conferences with providers of service, support members in creating and adhering to person-centered care plans. Additionally, the Clinical Care Manager will be coordinating services with other departments, providers, programs, and community partners, as needed, to provide support.
This care manager will have a focus on Behavioral Health Treatment (BHT) services for Youth under 21 with Autism and Mental Health and Substance use Treatment.
Duties & Responsibilities
Essential Functions:
- Manage a panel of assigned members to guide along the continuum of care to the optimal functional level and quality of life.
- Conduct comprehensive assessments and annual or as needed reassessments of the member’s psychosocial, physical health, functional abilities, and social determinants of health.
- Develop an individualized care plan based on assessment information that is member-centered, comprehensive and consistent with program guidelines and policies and procedures.
- Identifies member’s need for special programs, Behavioral Health Services, community supports and other services to fill gaps in care, monitors effectiveness of services.
- Conducts outreach to members for care plan review, needs assessment and acuity monitoring.
- Establishes and maintains open and effective communication with physicians and other healthcare and social service workers. Provides appropriate information on all significant aspects of member’s care and program operations, while maintaining necessary confidentiality.
- Maintains necessary and complete documentation for all case management activities in the plan’s case management system, MedHOK.
- Leads and/or participates in clinical huddles and interdisciplinary care team meetings with internal HPSM staff and external partners and providers.
- Make referrals to various HPSM departments, community-based organizations, and governmental agencies when health and/or psychosocial condition(s) indicate need for appropriate referrals(s).
- Promotes clear communication amongst the care team, which can include family and community support, and treating providers by ensuring awareness regarding member care plans, and when supporting care transitions.
- Teach appropriate interventions, link to resources, educate about benefits, and discuss medication effects and side effects to patients, caregivers, volunteers, and others as appropriate.
- Adhere to case management practice standards at all times.
- Participate in continuous quality improvement efforts.
- Maintain knowledge of HPSM benefits, programs, and processes, in order to provide clear information to members and providers.
- Maintain knowledge of community resources and programs.
- Maintain working knowledge of confidentiality practices and standards. Adheres to all standards of confidentiality and patient health information.
Secondary Functions:
- Perform other duties as assigned
Requirements
These are the qualifications typically needed to succeed in this position. However, you don’t need to meet every requirement to apply.
Education and experience
- Two (2) years clinical experience with Autism treatment, behavioral health or service coordination.
- Three (3) years of managed care experience preferably in Care Coordination or working with the health needs of the population served.
- Valid California license as a Registered Nurse or LVN, LCSW, LMFT. PHN preferred. Will consider unlicensed Masters Level Social Worker (MSW/ASW).
- Certification as Certified Case Manager (CCM) preferred.
Knowledge of:
- Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint.
- Case management principles and practices.
- Behavioral health programs and services and health care public policy issues.
- Relationship building and interpersonal skills.
- Strong knowledge of Medicare and Medi-Cal programs and benefits.
- Advanced knowledge of community resources.
- Knowledge of the complexities of working with the behavioral health issues and other vulnerable and disabled populations.
- Family systems
- Expanded knowledge of social determinants of health.
- HIPAA and other applicable federal and state regulations for confidentiality
Skills:
- Demonstrate member, provider and interdisciplinary team focused interpersonal skills.
- Work effectively with people in varying positions and diverse backgrounds, by maintaining cultural competency, knowledge and practice.
- Communicate effectively through written, verbal and listening communication skills.
- Conflict resolution, assertiveness, and collaboration skills
- Bilingual in Spanish
Ability to:
- Work cooperatively with others.
- Work as part of a team and support team decisions.
- Communicate effectively, both verbally and in writing
- Adapt to changes in requirements/priorities for daily and specialized tasks.
- Think critically and make informed decisions.
- Utilize member-centric approach to care coordination.
- Function effectively in a fluid, dynamic, and rapidly changing environment.
- Influence and gain consensus on individual and group decision-making.
Salary and benefits
The starting salary range is $43.00 - $57.00, depending on the candidate’s work experience.
Excellent benefits package includes:
- HPSM-paid premiums for employee’s medical, dental and vision coverage (employee pays 10% of each dependent’s premiums)
- Fully paid life, AD&D and LTD insurance
- Retirement plan (HPSM contributes equivalent of 10% of annual compensation)
- 13 paid holidays a year, 12 paid sick days a year and paid vacation starting at 16 days a year
- Tuition reimbursement plan
- Employee wellness program
To apply, submit a resume to careers@hpsm.org.
It is HPSM's policy to provide equal employment opportunities for all applicants and employees. HPSM does not unlawfully discriminate based on race, religion, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex, age, sexual orientation, veteran status, registered domestic partner status, genetic information, gender, gender identity, gender expression, or any other characteristic protected by applicable federal, state, or local law. HPSM also prohibits discrimination based on the perception that an applicant or employee has any of those characteristics or is associated with a person who has or is perceived to have any of those characteristics.
Job Type: Full-time
Pay: $43.05 - $57.05 per hour
Benefits:
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible schedule
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Parental leave
- Professional development assistance
- Referral program
- Retirement plan
- Tuition reimbursement
- Vision insurance
Schedule:
Application Question(s):
- Please only apply if you reside in California.
- Must have: Licensed Master's degree in Psychology, Social Work, Counseling, or Marriage/Family Counseling, BCBA, or
Licensed Ph.D. with 2 or more years of behavioral/mental health experience.
Education:
Work Location: Hybrid remote in South San Francisco, CA 94080