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Case Manager

Company Name:
ValueOptions, Inc., a Beacon Health Options company
ValueOptions, Inc., a Beacon Health Options company
Case Manager
ValueOptions is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled.
Position Location: NY - Latham
AAP Reporting Location:
ID: 33370
Job Family: Clinical, Licensed
Functional Area: CLINICAL OPERATIONS
FTE Status:
Scheduled Weekly Work Hrs: 40
Workday Schedule: Weekdays Only
Workday Start Time: 9AM
Workday End Time: 6PM
Variable Work Schedule:
The Case Manager is responsible for outreaching, triaging, assessing, and managing of members referred to Case Management. Responsible for the tracking and managing of members identified as Intensive Case Management (ICM) who may be high risk, high utilizing, at significant clinical risk or under-utilizing services.
Responsibilities The main responsibilities of the Case Manager include:
Identification of all assigned Intensive Case Manager Members outreach and engagement of members
Independent and individualized assessment of members enrolled in Intensive Case Manager .
Development of a member centric care plan in collaboration with the member and his/her treatment team
Managing, coordinating care, and identifying strategies to meet care plan goals of assigned Intensive Case Manager Members
Collaboration with community based providers
Utilization Review for designated Intensive Case Manager Clients for diversionary levels of care
Assist in collection of outcomes information, annual analysis and other reporting and initiatives
Telephonic collaboration and coordination with provider and community agencies regarding Intensive Case Manager members and care planning meetings as needed
Assist with NCQA and URAC initiatives
Urgent and crisis calls
Treatment Record Reviews
Attend Clinical meetings
Utilization Review of non- Intensive Case Manager members as needed
Other duties as assigned
Requirements
The successful Case Manager candidate will possess the following qualifications: Master's Degree
A current valid unrestricted NY license in behavioral health (LCSW, LMHC, LMFT) and Nursing RN
Minimum of two (3) years of combined direct behavioral health clinical and managed care experience
Current, valid and unrestricted independent licensure for practice required with proof on date of hire. Re-verification will take place no less than every 3 years.
Demonstrated experience establishing relationships and effectively engaging with members and providers through telephonic communication to obtain necessary information for the purposes of care management and coordination.
Demonstrated work experience meeting strict deadlines and established cycle times through effective prioritization and follow-up skills.
Case Managers are required to be educated in current principles, procedures and knowledge domains of case management based on nationally recognized standards of case management and must be a licensed behavioral health clinician or RN All case managers must practice within the scope of their license.
Please note, the position is location in Syracuse, New York.
PI91508232

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