Case Management

4 days ago

Long Beach, United States Blue Shield of California Full time

Your Role

Reporting to the Manager, Social Services Management, the Case Manager - Clinician, Senior helps members with behavioral health needs navigate the health care system for linkages to behavioral health providers, treatment, and program. The Case Manager - Clinician, Senior helps will offer support in assessing member’s emotional and psychological well-being and providing resource coordination, crisis intervention, substance abuse, and with any behavioral or mental health referrals. The Case Manager - Clinician, Senior helps will be available to physicians and nurse care managers as a consultant for patients with complex psychosocial needs. The position demands for an intensive focus on crisis intervention and counseling, problem-solving and conflict resolution, patient and family management, interdisciplinary collaboration, psychosocial assessments, education, advocacy, and community resource linkages.

Your Work

In this role, you will:

  • Collaborate with case managers and other team members tocomplete member assessments related to social and resource needs tosupportmemberaccess to services
  • Collaborate with service coordination staff and act as liaison to ensure timely and accurate response to member need
  • Collaborate with providers to support members treatment plan and care needs
  • Recognize the clients right to self-determination as it relates to the ethical principle of autonomy, including the client/family's right to make informed choices that may not promote the best outcomes, as determined by the healthcare team
  • Assessmembers health behaviors, cultural influences and clients belief/value systemand evaluates all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriers
  • Efficiently manages and maintains a caseload of members for behavioral health care coordination and or BH case management for persons experiencing severe and persistent mental illness.
  • Maintains an active workload in accordance with National Care Manager performance standards.
  • Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.
  • Interacts with Utilization department and Physician Advisors to discuss clinical questions and concerns regarding specific cases.
  • Coordinates services with state and community programs on behalf of the member, particularly when the member is unable to effectively do so independently
  • As a mandated reporter, files and follows-up on reports made to the appropriate government agency (e.g., Adult Protective Services, Child Protective Services, etc.)
  • Actively participates in Interdisciplinary Team Meetings and case consultations with Licensed Manager.)

Your Knowledge and Experience

  • Current unrestricted California RN, LMFT, LCSW or psychologist license with completed corresponding college education is required (I.e. RN – associate’s and/or bachelor’s degree in nursing, LMFT – master’s degree in marriage and family therapy, LCSW – master’s degree in social work, psychologist – doctorate degree in psychology)
  • Requires at least 5 years of prior relevant experience, with 3 years of experience working with the Medi-Cal population, medical social work, community clinics, or other home and community-based organizations preferred
  • LCSW, LMFT, or PSYD Board of Behavioral Sciences certification preferred
  • Certified Case Manager preferred
  • Experience conducting thorough psychosocial assessments, developing care plans and providing necessary interventions identified during assessment with complex client populations that may have, among other things, inadequate coping skills, severe emotional disorders, developmental disabilities, mental illnesses, and/or unstable housing
  • Considerable knowledge of a wide range of psychosocial challenges and familiarity with behavioral health diagnoses and treatment
  • Proficient with computer programs such as Microsoft Excel, Outlook, Word, and PowerPoint

Pay Range:

The pay range for this role is: $ 77990.00 to $ 116930.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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