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Behavioral Health Care Manager
1 month ago
At MetroPlus Health Plan, we are committed to empowering New Yorkers by uniting communities through care. We believe that healthcare is a right, not a privilege. If you have compassion and a collaborative spirit, we invite you to join our team.
About the RoleThe Behavioral Health Care Manager develops, facilitates, and communicates a plan of care in partnership with the member, their assigned Health Home, primary caregiver, the primary and attending physicians, and various Behavioral Health and/or substance use disorder providers. This position collaborates with the aforementioned parties to assess, plan, facilitate, and advocate for options and services to meet a member's behavioral health needs through communication and available resources.
Key Responsibilities- Clinically assess members for acute behavioral and physical health needs, generating referrals to providers, community-based resources, and appropriate services to assist in goal achievement.
- Meet with members in their homes, shelters, other residential settings, at community agencies, hospital inpatient units, and/or day hospital programs.
- Conduct initial and ongoing Behavioral Health clinical assessments.
- Develop a formal plan of care for all services needed for the member.
- Notify physicians for any changes in member's plan of care and follow up with assigned nurses for clinical updates to plans of care.
- Document IDT care coordination notes between internal MetroPlusHealth staff and external BH providers and caregivers.
- Attend and prepare for bi-Weekly Interdisciplinary Care Team (ICT) meetings featuring newly enrolled, frequently admitted, high utilizing at-risk members.
- Assist members with the coordination of services from various settings as appropriate, including facilitating discharge from acute settings and alternate settings.
- Provide care coordination throughout the continuum of care, optimizing both the quality of care and the quality of life for MetroPlus members.
- Assist providers with achieving pay for performance goals and examine the feasibility of Value-Based Payment with high-volume providers for Mainstream Medicaid.
- Educate providers on medication and treatment compliance while promoting the use of Long-Acting Injectables.
- Enlist existing provider networks in promoting first-episode psychosis treatment.
- Document in a comprehensive manner to ensure that all goals, interventions, and care coordination activities for each member in DCMS system and other applicable software programs are compliant with professional standards and regulatory guidelines.
- Evaluate housing needs appropriately and assist with housing application processes, collaborating timely with MetroPlus internal housing teams for supportive assistance.
- Contribute to MetroPlus corporate goals through ongoing execution of member care plans and member goal achievement.
- Perform other appropriate Behavioral Health Departmental duties and participate in other special projects as assigned, including audit review and preparation, quality improvement, community health education, facility/provider relations, and marketing activities.
