Behavioral Health Navigator

4 weeks ago

Santa Barbara, United States CenCal Health Full time

California Payrate range: $32.35 - $46.91 per hour

**Job Summary**

This position will assist with the coordination of care issues. The Behavioral Health Navigator will help members access Behavioral Health services promptly, provide:

- Coaching related to psychoeducation of mental health symptoms.
- The importance of treatment plan compliance.
- Utilization of appropriate mental health resources.
- Appropriate use of CenCal mental health or behavioral health treatment benefits.
- Use of other community resources.

This position will initially support the Behavioral Health Department, receiving Member follow-up tasks from teams and the Call Center. Depending on task volume, it may be assigned to primarily support a specific team or call center.

**Duties and Responsibilities**
- Assesses members' needs and develops plans to support members' access to care through appointment scheduling, education, and care coordination with primary care physicians, mental health practitioners, county providers, and community-based organizations.
- Maintains ongoing health records by state, organizational, and NCQA regulations and in keeping with accepted community standards.
- Utilizes resources of public and private agencies and community organizations to meet the members' needs.
- Provides appropriate support to members and their families, including explanation of treatment and benefits, instructions on how to support treatment, and interventions to increase acceptance of and adherence to treatment.
- Ensures care coordination, patient education, and information and referrals based on member's assessment of needs, member's request, or policy and procedure.
- Engages collaboratively with community-based and government agencies to assure continuity and coordination of care for your patients
- Participates in data collection and management.
- Demonstrates ability to manage multiple member referrals while maintaining daily productivity of all requests assigned.
- Participates in consultation, peer review, team activities, and meetings.
- Coordinate appropriate member assistance for scheduling appointments for mental health services and other tasks as Behavioral Health Department staff requested.
- Coordinate document efforts in appropriate systems and with referring providers and other departments, such as Case Management, within expected time frames.
- Adhere to all CenCal Health Policies and Procedures and meet required performance standards.
- Works collaboratively with internal and external teams.
- Ensures compliance with Medi-Cal requirements for timely access to care, turnaround time, and other organizational policies and procedures.
- As requested, participate in the audit, audit readiness, and other related organizational activities.
- Supports organizational and departmental strategic planning initiatives and goals.
- Ensures coverage of the behavioral health call center as assigned.
- Other duties and responsibilities as assigned.

**Knowledge/Skills/Abilities**

**Required**:

- Knowledge and experience in mental health services to Medi-Cal and county systems of care.
- Effective problem solver who uses sound judgment and quickly identifies and understands issues, problems, and opportunities; uses case management principles, best practices, and data to evaluate alternatives and recommend solutions.
- Ability to be attentive to the diverse needs of each client and secure relevant client care data to identify key issues in managing care while simultaneously managing high-volume client cases.

**Preferred**:

- Bilingual
- Knowledge of Medi-Cal eligibility-related issues, DSS, SSA, TCRC inter-workings, and an understanding of the State’s beneficiary assignment and processes related to the Plan.
- Must demonstrate complete knowledge and understanding and possess a high level of skill set and proficiency with Microsoft Office Suite, including Outlook, Word, and Excel
- Coordination skills relating to Care Management requests and understanding fundamental principles and practices for appropriate hand-offs and follow-through with clinical teams.
- Excellent and effective oral and written communication skills, including member coaching and strong interpersonal skills.
- Must demonstrate, upon completion of orientation and training modules, a thorough understanding of CenCal’s various healthcare program benefits and applicable co-payments, eligibility, coordination with the local government and CBO agencies, pharmacy formulary, and provider network.
- Must possess a positive attitude and contribute to the success of the department and team.
- Strong ability to work effectively under pressure and independently with mínimal supervision.
- Ability to manage multiple priorities and assume special projects over and above assigned responsibilities.

**Education and Experience**
- Undergraduate degree in psychology, social work, or counseling, or four (4) years’ experience in a managed care environment working with the u

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