Behavioral Health Case Manager RN

2 weeks ago

California, United States Regal Medical Group Full time

Area of Interest Utilization/Quality Management Position Type Full-time Job Description Position Summary: The Behavioral Health Case Manager RN collaborates with an inter-disciplinary care team to provide patient-centered case management and support to members with primary need for behavioral health services. Promotes and ensures ongoing engagement in behavioral health services. Helps to mitigate psychosocial and behavioral health drivers of preventable healthcare utilization and promote ongoing health management. Work primarily with complex and vulnerable populations with an emphasis on: removing barriers to treatment compliance, linkage to and ongoing engagement with appropriate behavioral health services; increasing member engagement with Regal, community-based and public/social services; and promoting overall health and wellness through evidence-based interventions. Essential Duties and Responsibilities include the following: Management/monitoring of Behavioral Health patients to include periodic phone calls and in-person visits, post-hospital follow-up and direct contact in acute (hospital/skilled nursing facility), clinic and community settings. Communicate and facilitate coordination of care with and between the primary care physician, specialty care providers, interdisciplinary care team, member, member’s family and caregivers, to promote development of, and adherence to, appropriate treatment plans. Develops actionable care plans for members including patient-centered SMART goals. Use effective relationship management, resource management, advocacy, and pertinent interventions to: Promote improved quality of care and patient quality of life. Promote maintenance or improvement of functional level Promote cost effective medical interventions and outcomes. Prevent hospitalization and readmission whenever possible and appropriate. Attends all required intervention visits in accordance with program protocols. Attend daily outpatient meetings, and other interdisciplinary team meetings, as appropriate. Actively participate in Interdisciplinary Care Team meetings by presenting appropriate Behavioral Health cases for discussion and contribute at meetings to promote total case management. Document patient assessment and reassessment, patient care plans, and other pertinent information completed in the patient’s medical records in accordance with organizational standards and policies. Consults with other departments as appropriate to provide for an interdisciplinary approach to the patient’s needs. Record accurate information in all required documentation systems in accordance with company policy, compliance regulations and quality standards. May assume leadership role of inter-disciplinary care team when appropriate. Maintain strong working knowledge of healthcare system, behavioral health providers and delegations of risk for behavioral health services by line of business for the company, as well as organization’s outpatient care protocols. Identifies root drivers of hospital admissions Identifies community resources to address patients’ needs. All other duties as assigned. The pay range for this position at commencement of employment is expected to be between $45.00 - $50.00 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience. The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment. If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors. As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success. Full Time Position Benefits: The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life. Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options. Health and Wellness: Employer-paid comprehensive medical, pharmacy, and dental for employees Vision insurance Zero co-payments for employed physician office visits Flexible Spending Account (FSA) Employer-Paid Life Insurance Employee Assistance Program (EAP) Behavioral Health Services Savings and Retirement: 401k Retirement Savings Plan Income Protection Insurance Other Benefits: Vacation Time Company celebrations Employee Assistance Program Employee Referral Bonus Tuition Reimbursement License Renewal CEU Cost Reimbursement Program Business-casual working environment Sick days Paid holidays Mileage Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance. Requirements Education and/or Experience: 5+ years of Behavioral Health case management experience Bachelor’s degree (required) in psychology, social work, or related field, or current CA RN license Master’s degree (preferred) in psychology, social work (with licensure) or related field or current CA RN license Valid CA Driver’s license Experience with Medi-Cal beneficiaries preferred. Bilingual (Spanish or Armenian) highly preferred.

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