Behavioral Health Care Manager

Miami Dade County, FL

Posted: 03/02/2023 Job Number: 118481

Job Description


Behavioral Health Care Manager LCSW, LMFT or LMHC openings with a major health insurance / managed care company based in the Miami, FL 33127 area! Starting ASAP! Apply now with Luke H. at A-Line!

**Must reside in Miami Dade County, and must have one of the following Licenses: LCSW, LMFT or LMHC**

Required Experience:
  • Must have experience with Mental Health / Behavioral Health, case management and field experience
  • Must have a valid FL license in LCSW, LMFT or LMHC
  • Required A Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position
  • Required 2+ years of experience in behavioral health management and/or acute behavioral health care setting focusing on outpatient/inpatient utilization, case management and discharge planning
  • Required 1+ year of experience in current case management as a licensed professional
  • Required Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
  • Preferred Experience in a managed care environment
  • Licenses and Certifications: A license in one of the following is required:
    • A master's level independent or non-independent license is required
    • Required Licensed Clinical Social Worker (LCSW)
    • Required Licensed Clinical Mental Health Counselor (LCMHC)
    • Required Licensed Clinical Marriage & Family Therapist (LCMFT)


Salary: $65,000 – $80,000 / yr
Schedule: Mon-Fri (40 hours/week | 8 hours/day)

Job Summary:
  • Conducts comprehensive member psychosocial assessments through root cause analysis and performs clinical intervention through the development of a care management treatment plan specific to each member with high level acuity needs. Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability. Assess members to recommend activities and behavioral routines to meet the social and medical needs of members and their families. Provides support and/or intervention and assists members in understanding the implications and complexities of their current medical situation and/or overall personal care.
  • This is a Case management position that supports our SMI (serious mental illness) members. It is remote but we do field visits with our members New: This is a Case management position that supports our SMI (serious mental illness) members. It is remote but we do field visits with our members.

 

Job Duties:
  • Assesses, plans, implements, monitors and evaluates options and services to meet complex psychosocial health needs of inpatient and outpatient members. Manages a caseload in compliance with contractual obligations and WellCare standards.
  • Conducts comprehensive member assessments through root cause analysis based on referred member's needs and benefit plan eligibility, and performs clinical intervention through the development of a care management treatment plan specific to each member with high level acuity needs.
  • Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability. Works towards achievement of optimal clinical and resource outcomes.
  • Monitors and evaluates effectiveness of care plan and modifies plan as needed. Supports member access to appropriate quality and cost effective care. Coordinates with internal and external resources to meet identified needs of the member's care plan and collaborates with providers.
  • Acts as a liaison and member advocate between the member/family, physician and facilities/agencies.
  • Provides clinical consultation to physicians, professional staff and other teams members/supervisors to provide optimal quality patient care and effective operations.
  • Interacts continuously with members, family, physician(s), and other resources to determine appropriate behavioral action needed to address medical needs. Reviews benefits options, researches community resources, trains/creates behavioral routines and enables members to be active participants in their own healthcare.
  • Ensures members are engaging with their PCP to complete their care management treatment plan or preventive care services.
  • Assists in obtaining benefits for members through community resources when benefits are exhausted or not available.
  • Incumbents engaged in Florida's SMI program will manage members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability.
  • Incumbents will travel extensively to member's inpatient bedside, home or other facility.

 

Our Comprehensive Benefits Package:
  • Flexible work solutions including remote options, hybrid work schedules and dress flexibility
  • Competitive pay
  • Paid time off including holidays
  • Health insurance coverage for you and your dependents
  • 401(k) and stock purchase plans
  • Tuition reimbursement and best-in-class training and development


Keywords: Licensed Professional Counselor; Licensed Clinical Social Worker; Licensed Marriage and Family Therapist; Licensed Psychologist; Licensed Independent Substance Abuse Counselor, Licensed Associate Counselor; Licensed Associate Substance Abuse Counselor; Licensed Masters Social Worker; Registered Nurse Behavioral Health, Behavioral Health, Mental Health, Provider Services, Counseling, Crisis Counselor, Credentialing, DSM, Medical Coding, Medical Billing, Concurrent Review, Denials, Grievance, Grievance and Appeals, Appeals and Denials, Utilization Review, Case Management, CCM, Case Manager, URAC, HEDIS, STARS, InterQual, CMS, Medicare, Medicaid, Utilization Management, Telephonic, PBM, Claims, Rx, Certified Case Manager, Care Coordination, Health Plan, Health Insurance, MCO, Managed Care, Medical Claims, Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Patient Counselor, Healthcare.
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