BH Case Management Team Lead

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
• Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
• Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve. Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers. JOB SUMMARY The Behavioral Health Case Management Team Lead will manage CHC members with behavioral health diagnosis through comprehensive evaluation and through coordination of resources. The Behavioral Health Case Management Team Lead will participate as a team member in CHC Behavioral Health Department. The Behavioral Health Case Management Team Lead will work collaboratively with utilization management, member services and the quality improvement departments. JOB SPECIFICATIONS AND CORE COMPETENCIES Coordinates daily operational aspects of team and assists manager with staff supervision Monitors and facilitates equal distribution of workload assignments Assists manager in setting productivity goals Monitors Coordinators and Behavioral Health Case Managers to ensure performance and productivity metrics are met Reviews and documents staff productivity on monthly and ad hoc basis Informs manager about escalated issues and works with manager to resolve them Monitors adherence to attendance, PTO, lunch, and break guidelines Quality/Process Improvement Complete quality audits by comparing productivity sheets to recorded calls and documentation in the system Provides information for employee performance reviews. Identifies training needs Ensures that staff completes required training Holds monthly team meetings with staff and documents minutes Evaluations of team members and any necessary improvement plans Completes documentation and call monitoring audits quarterly and ad hoc Assists with new and ongoing employee training and development of training documents Identifies opportunities for process and productivity improvement and shares with manager Assist with the development of policy and procedures and job aides pertaining to the Behavioral Health Case Management Team Coaches and mentors staff on issues identified Assist with Program Management Development and/or redesign of the Behavioral Case Management Program Recommend improvements to the Behavioral Health Case Management Program Development or redesign of program materials Maintain and report required Program Analytic requirements. Complete special projects as assigned Actively contributes to achievement of departmental goals, as identified in Departments annual business plan, including specific departmental process improvement plans Other duties as assigned. QUALIFICATIONS: Education/Specialized Training/Licensure: Master's Degree in Social Work, Counseling required. LMSW, LCSW, LPC, LMFT required. CCM, ACM preferred. Work Experience (Years and Area): Minimum of 4-years BH Case Management to include Minimum of 1 Year MCO experience Software Proficiencies: Microsoft Office (Word, Outlook, Excel) #J-18808-Ljbffr Community Health Choice, Inc.