Jobs · OTHR

Behavioral Health Care Manager

WellCare of Kentucky · Ohio, United States · 2 days ago
RemoteRemoteOTHR$56k–$101k/yrFull-time

About the role

Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substance use disorder.

Responsibilities

  • Evaluates the needs of the member via phone or in-home visits related to the resources available, and recommends and/or facilitates the care plan/service plan for the best outcome, which may include behavioral health and social determinant needs
  • May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources
  • Develops ongoing care plans for members with high level acuity and works to identify providers, specialists, and community resources needed for care including mental health and substance use disorders
  • Coordinates as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members
  • Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs
  • Facilitates care coordination and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services
  • Collects, documents, and maintains member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
  • Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs
  • Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
  • Performs other duties as assigned
  • Complies with all policies and standards

Requirements

  • Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2 – 4 years of related experience
  • Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience required
  • Preference given to applicants who reside in Kentucky or its bordering states (Ohio, Indiana, West Virginia, or Tennessee)
  • Active independent Kentucky licensure (especially an LCSW or LPCC) preferred
  • Experience with case management and mental health services including serious mental illness (SMI) or substance use disorder

Benefits

  • Competitive pay
  • Health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off plus holidays
  • Flexible approach to work with remote, hybrid, field or office work schedules

Pay

$56,200.00 - $101,000.00 per year. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives.

Schedule

Monday through Friday, 8-5 PM Eastern.

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