Case Manager I

Case Manager I

Location: Remote + Field Visit (Albuquerque or Las Cruces)

Duration: 3 Months+ (Possible Extension)

Schedule: 8 Am – 5 Pm Mon - Fri (MST)

Travel: There will be travel associated. The candidate chosen would be expected to travel to member residences, community-based agencies within city/county limits and potential for surrounding counties within the catchment area to engage.

Job Description

Is this a temp to hire position? It could be in the future but not right now.

Required Licensure / Education

• The care management personnel must hold one of the licenses (or relevant state equivalent) below to participate in the initiative:
• Clinical Social Workers (ex. LCSW, LISCW)
• Professional Counsellors/Licensed Mental Health Counsellors (ex. LPC/LPCC, LMHC)
• Marriage and Family Therapists (LMFT)
• Certified Alcohol and Drug Counsellor (CADC)
• Substance Use Disorder Professional (SUDP)
• These staff should have unrestricted license in the state in which they are working as a care manager and a National Provider Identifier.

Required Years of Experience

3 years

• The utilization of specific care management staff to conduct visits (telephonic or face-to-face to satisfy the requirements of multiple Behavioral health follow-up measures (FUH, FUM, FUI, and IET).
• Measures In Product:
• FUH - Follow up After Hospitalization for Mental Illness
• FUM - Follow up After Emergency Department Visit for Mental Illness
• FUI - Follow up After High Intensity Care for Substance Disorder
• IET-Initiation and Engagement of Alcohol and other Drug Abuse or Dependence Treatment

Must Have Skills

• Active, unrestricted Behavioral health clinical license in the state of practice (LCSW/LISW, LPC/LPCC/LMHC, LMFT, CADC, SUDP, or state equivalent) · National Provider Identifier (NPI) required
• Minimum of 3 years of experience in Behavioral health, substance use disorder treatment, care management, or a related clinical setting
• Demonstrated Behavioral health care management experience, including transitional support following hospitalizations or emergency department visits.
• Strong working knowledge of Behavioral health quality and HEDIS measures, including FUH, FUM, FUI, and IE
• Proven ability to conduct telephonic and/or face-to-face outreach with members to support follow-up care · Experience scheduling and coordinating appointments with Behavioral health providers or internal care teams. Ability to utilize established care management programs to provide ongoing member support
• Excellent clinical documentation skills, with the ability to accurately document member interactions in accordance with job aides and compliance requirements.
• Strong communication and collaboration skills, including the ability to work with leadership and interdisciplinary teams
• Demonstrated ability to handle and protect PHI in compliance with healthcare privacy and security standards

Day to Day Responsibilities

• CM staff responsibilities include reaching out to members identified for transitional support.
• Scheduling appointments with members' Behavioral health treatment providers or Care Connections.
• Utilizing existing care management programs to provide ongoing member support.
• Documenting all member interactions, ensuring compliance with the job aide to contribute to HEDIS goals.
• Communicating with local leadership regarding any questions or concerns about the procedures.