Care Manager at Spectraforce Technologies
Job Description
Position Title: Care Manager
Assignment Duration: 3 Months (Possibility to extend or convert?)
Work Location: Region 3 (Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee and Union counties)
Work Arrangement: Remote
Work Schedule: Monday - Friday, 8 - 5
Position Summary:
Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substance use disorder.
Key Responsibilities:
- Evaluates the needs of the member via phone or in-home visits related to the resources available, and recommends and/or facilitates the care plan/service plan for the best outcome, which may include behavioral health and social determinant needs
- May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources
- Develops ongoing care plans for members with high level acuity and works to identify providers, specialists, and community resources needed for care including mental health and substance use disorders
- Coordinates as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members
- Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs
- Facilitates care coordination and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services
- Collects, documents, and maintains member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
- Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs
- Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
- Performs other duties as assigned.
- Complies with all policies and standards.
- Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2 - 4 years of related experience.
- Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience required
- Employees supporting Florida's Children's Medical Services must Hold a Master's degree in social work or related field and have one year of related professional pediatric care experience.
- Must reside in the state of Florida.
- Bilingual candidates highly preferred.
| Education/Certification | Required: Social Work, Psychology, Mental Health, Counselor Education | Preferred: Social Work, Psychology, Mental Health, Counselor Education | ||
| Licensure | Required: LCSW or LMHC | Preferred: LCSW or LMHC | ||
| Must haves: At least 5 years' experience working in the field with children and families and the system of care. Excellent computer skills in Microsoft, able to learn and navigate various platforms. Nice to haves: Qualified Supervisors; Clinical Supervisor experience, experience with DCF, DJJ, APD, DOH and /or a CBC or ME. Disqualifiers: N/A Performance indicators: able to multitask, manage high needs members, manage children and family members with mental health illness; provide excellent customer service; partner and work collaboratively with all providers/stakeholders. Manage challenging cases with multiple barriers. Best vs. average: | |||
| 1 | Excellent Clinical Documentation and able to present cases succinctly on various platforms/teams. | ||
| 2 | Understanding and able to navigate the system of care/ connect with in-network providers and have an excellent understanding of the region/circuit processes for staffing members assigned to our plan. | |||
| 3 | Excellent computer skills - able to utilize multiple systems/platforms | |||
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