Clinical Care Management Specialist

2 months ago

Philadelphia, United States Community Behavioral Health. Full time
Job DescriptionJob DescriptionThe Clinical Care Management Specialist/Integrated Care Specialist provides clinical recommendations and collaborative support to team members and physical health care staff involved in the Integrated Care Plan (ICP) Program. The Clinical Care Management Specialist reviews clinical information using a holistic care framework, makes recommendations for appropriate levels of care, creates Integrated Care Plans and coordinates services for individuals referred to the ICP team.

Essential Functions:

  • CCMS will travel amongst the identified community partnership sites and participate in case information sharing as scheduled.
  • CCMS will develop a schedule with each practice site, PH MCO and CBH team staff for onsite visits to consent members for participation in the Integrated Care Plan Program, share released information with the PH MCO and discuss case recommendations with the appropriate internal staff.
  • CCMS will complete Integrated Care Plans as outlined by the policies and regulations of CBH and the state.
  • CCMS will create Integrated Care Plans for members referred from community partners, internal referrals for ICP development and for members who meet appropriate criteria for integrated care planning.
  • During the case collaborations with sites and PH MCOs, CCMS will provide behavioral health treatment utilization and develop care plans tailored to the individual’s current needs as part of the treatment team.
  • CCMS will coordinate with internal CBH staff to ensure communication and collaboration is clear and the individual’s developed care plan is carried out as such.
  • CCMS will participate in the problem solving process and provide information on additional community resources as needed.
  • CCMS will do utilization review as necessary for assigned members, implementing medical necessity criteria to inform level of care determinations.
  • CCMS will document and track their interventions and share data internally and with associated partners, like PH MCOs and community partnership sites.

Position Requirements:

  • Education: Master’s degree in Social Work or related field
  • License/Certification: License preferred or must be eligible within 1 year of hire; PA Child Abuse Clearance required; other health related clearances might be required based on the community sites you are partnered with and their requirements for working on site.
  • Relevant Work Experience: Minimum of 3 years of direct clinical care experience working with adults in behavioral health or physical health settings; experience in assessment and treatment planning and/or experience in a managed care setting. Must possess knowledge of evidence-based treatment for behavioral health challenges to make appropriate referrals for care.

Skills:

  • Ability to work collaboratively with cross-system partners
  • Excellent verbal and written communication skills and ability to interact with broad range of individuals
  • Strong mediation skills
  • Computer proficiency and ability to type at least 20 words per minute
  • Ability to work independently in fast-paced environment
  • Compliant with HIPAA regulations

Work Conditions (including travel, overtime required, physical requirements and occupational exposure):

  • This position spends the majority of time in the field and requires travel within Philadelphia and surrounding counties.
  • Regularly requires walking, standing, stooping, bending, sitting, reaching, pushing, pulling and/or repetitive wrist/hand movements for various lengths of time throughout the day.
  • Ability to utilize computers and office equipment to complete daily work responsibilities.
  • Requires continuous, normal hearing and vision.
  • Regularly works inside in areas that are adequately lighted and ventilated. Some fluctuation in temperature. No protective equipment routinely needed.
  • Must be able to adapt to continuous changes/demands of the job.

Philadelphia Residency Requirement:

  • The successful candidate must be a current Philadelphia resident or become a resident within six months of hire.

Equal Employment Opportunity:

  • We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CBH is an equal opportunity employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on all qualified individuals. This is without regard to race, ethnicity, creed, color, religion, national origin, age, sex/gender, marital status, gender identity, sexual orientation, gender identity or expression, disability, protected veteran status, genetic information or any other characteristic protected individual genetic information, or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function by applicable federal, state, or local law.

Requesting An Accommodation:

  • CBH is committed to providing equal employment opportunities for individuals with disabilities or religious observance, including reasonable accommodation when needed. If you are hired by CBH and require an accommodation to perform the essential functions of your role, you will be asked to participate in our accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodation once hired.
  • If you would like to be considered for employment opportunities with CBH and have accommodation needs for a disability or religious observance, please send us an email at CBH.Recruitment@Phila.gov

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