Health Plan Behavioral Care Manager (Onsite)

Job Summary Assumes responsibility for utilization and case management of behavioral health cases. Collaborates with other staff in co-management of more complex cases. Contributes to the Population Health Plan Initiative. Job Location Roseville, California (metropolitan area of Sacramento) Responsibilities Case manage or co-manage with care management nurses for employees/dependents with behavioral health issues. Develop care plans and work with members and their providers toward effective outcomes. Support the proper utilization of resources. Perform concurrent and retrospective medical record/case reviews in accordance with the Care Management Program utilizing medical resources and clinical decision support tools. Function as liaison to members, providers, case coordinators, discharge planners, contracted health plans/partners and internal departments. Counsel members in behaviors conducive to health. Act as resource for care management nurses and wellness coaches. Develop focused programs as needed (e.g., drug seeking members). Assist with analytics review of claims data from varied sources relative to potential patient needs and program development. Develop programs in support of our population health initiative. Perform other job-related duties as assigned. Qualifications Education Associate's/Technical Degree or equivalent combination of education/related experience (Required) Bachelor's Degree (Preferred) Master's Degree in social work (LCSW) (Preferred) Doctor's or Master's Degree (LMFT) from an accredited school (Preferred) Experience Five years' clinical experience, including direct patient care (Preferred) Licenses/Certifications Licensed Clinical Social Worker or Licensed Psychologist (Required) Licensed Clinical Social Worker (LCSW) or Psychologist (PSYCH) (Required) Licensed Clinical Social Worker (LCSW) in state of practice (Required) Additional Requirements All associates must receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply. Adventist Health participates in E-Verify. #J-18808-Ljbffr Adventist Health