Clinical Care Management Specialist FOCUS
4 days ago
Community Behavioral Health (CBH) is seeking a highly skilled Clinical Care Management Specialist to join our team. As a Clinical Care Management Specialist, you will play a critical role in providing intermediate or high-intensity care management to our members, working collaboratively with them and their providers to ensure effective, holistic, and member-centric care.
Key Responsibilities:- Provide direct care management to members, including assessment, treatment planning, and coordination of services.
- Collaborate with members, their caregivers, and providers to develop and implement individualized care plans.
- Conduct utilization review activities, population management, cross-system consultation, and treatment quality monitoring.
- Facilitate care coordination with external entities, including behavioral and physical health providers, Child Welfare, Juvenile Justice, School district of Philadelphia, and Targeted Case Management (TCM).
- Address member/caregiver engagement in treatment by reporting or addressing any reported/observed quality concerns, resolving communication barriers between member (and/or caregiver) and providers, assisting member/caregiver with mediation issues/barriers, assisting with any clarification/prioritizing issues, increase positive collaboration with providers and other supports.
- Facilitate longitudinal care management of all assigned members.
- Masters degree in Social Work or related field.
- Willing/able to obtain licensure within first year of employment; PA Child Abuse Clearance required.
- Preferred Licensure: Licensed Social Worker (LSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW).
- Relevant Work Experience: Minimum of 3 years of direct clinical care experience working with adults, children, adolescents and/or their families in behavioral health settings and experience in assessment and treatment planning; and/or experience in a managed care setting.
- Teamwork and Collaboration: Build and sustain relationships with co-workers and stakeholders and support efforts and deliverables.
- Respect: Treat each other and our members and stakeholders with respect and sensitivity, recognizing the importance of diversity.
- Member Centric: Focus on the needs of our members by providing value-added services, promoting strong relationships and going beyond basic expectations to achieve the best possible outcomes.
- Honesty and Integrity: Be open and honest in all we do. Maintain the highest level of integrity at all times.
- Commitment to Service Excellence: Challenge ourselves to be forward-thinking and committed to providing total member and stakeholder satisfaction, first-in-class service and high quality, innovative programs.
- Compassion and Empathy: Demonstrate a deep appreciation for anothers situation and point of view. Pay attention to emotional cues, listen effectively and show an exceptional level of caring about each persons perspectives and circumstances.
- Problem Solving: Build and implement logical solutions to resolving challenges/issues by using individual knowledge and experience while taking resources, constraints and CBH values into consideration.
- Initiative and Self-Directed: Proactively manage time and resources in a way that ensures that all work is done in the most efficient manner while identifying and implementing initiatives without interventions from co-workers, supervisors or stakeholders.
- Flexibility and Adaptability: Adjust approaches and behaviors in order to meet the constantly changing environment head-on and accomplish CBH and individual goals. Strive to adapt to, accept and embrace change within areas of responsibility.
- Communication: Effectively and appropriately share thoughts, ideas and information - both written and oral. Respectfully listen to co-workers and stakeholders to gain a full understanding of issues/situations.
CBH is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to providing a work environment that is inclusive and respectful of all employees. If you are interested in this opportunity, please submit your application through our website.
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