Integrated Care Management Consultant

2 weeks ago

Philadelphia, Pennsylvania, United States Community Behavioral Health. Full time
Job Overview

The Integrated Care Management Consultant plays a pivotal role in providing clinical insights and collaborative assistance to team members and healthcare professionals engaged in the Integrated Care Plan (ICP) Program. This position involves a comprehensive review of clinical data through a holistic care approach, offering recommendations for suitable care levels, developing Integrated Care Plans, and orchestrating services for individuals referred to the ICP team.

Key Responsibilities:

  • The consultant will travel to designated community partnership locations and engage in scheduled case information exchanges.
  • They will establish a visit schedule with each practice site, collaborating with physical health managed care organizations (PH MCO) and community behavioral health (CBH) staff to consent members for the Integrated Care Plan Program, share authorized information, and discuss case recommendations.
  • Completion of Integrated Care Plans will be conducted in accordance with CBH policies and state regulations.
  • Creation of Integrated Care Plans for members referred by community partners, internal referrals for ICP development, and individuals meeting the criteria for integrated care planning will be a primary duty.
  • During collaborative case discussions with sites and PH MCOs, the consultant will provide insights on behavioral health treatment utilization and develop care plans tailored to the individual’s current needs as part of the treatment team.
  • Coordination with internal CBH staff will ensure clear communication and collaboration, facilitating the implementation of the developed care plan.
  • Participation in problem-solving processes and provision of information on additional community resources will be expected as needed.
  • Utilization reviews will be conducted as necessary for assigned members, applying medical necessity criteria to inform level of care decisions.
  • Documentation and tracking of interventions will be essential, with data shared internally and with relevant partners, including PH MCOs and community partnership sites.

Qualifications:

  • Education: Master’s degree in Social Work or a related discipline.
  • License/Certification: Preferred licensure or eligibility within one year of hire; PA Child Abuse Clearance required; additional health-related clearances may be necessary based on community site requirements.
  • Experience: A minimum of three years of direct clinical care experience with adults in behavioral health or physical health environments; experience in assessment and treatment planning, or in a managed care context is essential. Knowledge of evidence-based treatments for behavioral health challenges is required for appropriate referrals.

Skills:

  • Ability to collaborate effectively with cross-system partners.
  • Exceptional verbal and written communication skills, with the ability to engage a diverse range of individuals.
  • Strong mediation capabilities.
  • Proficiency in computer use and typing skills of at least 20 words per minute.
  • Capacity to work independently in a dynamic environment.
  • Adherence to HIPAA regulations is mandatory.

Work Environment:

  • This role primarily involves fieldwork, requiring travel within designated areas.
  • Regular activities include walking, standing, bending, sitting, reaching, and repetitive hand movements throughout the day.
  • Utilization of computers and office equipment is necessary for daily responsibilities.
  • Normal hearing and vision capabilities are required.
  • Work is typically conducted indoors in well-lit and ventilated spaces, with some temperature variations. No special protective equipment is routinely needed.
  • Adaptability to ongoing changes and demands of the role is essential.

Residency Requirement:

  • The successful candidate must be a resident of the area or commit to relocating within a specified timeframe after hiring.

Diversity and Inclusion:

  • We are dedicated to fostering a culture of diversity, inclusion, and belonging. Community Behavioral Health is an equal opportunity employer, ensuring that recruitment, hiring, promotion, and all personnel actions are conducted without discrimination based on race, ethnicity, creed, color, religion, national origin, age, sex/gender, marital status, gender identity, sexual orientation, disability, or any other characteristic protected by law.

Accommodation Requests:

  • Community Behavioral Health is committed to providing equal employment opportunities for individuals with disabilities or religious observance, including reasonable accommodations as needed. If hired, employees requiring accommodations to perform essential job functions will be engaged in an accommodation process.

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