LTSS Care Manager - LPC, LCSW, LMHC, or Psych RN

About the role

Develops, assesses and coordinates holistic care management activities, with primary focus and support towards populations with significant mental/behavioral health needs, to enable quality, cost-effective healthcare outcomes. Evaluates member service needs and develops or contributes to development of care plans/service plans, and educates members, their families and caregivers on services and benefits available to meet member needs.

Responsibilities

• Evaluates the needs of the most complex and high-risk members with mental/behavioral health needs, and recommends a plan of care for the best outcome
• Acts as liaison and member advocate between the member/family, physician, and facilities/agencies
• Supports members with primarily mental/behavioral health needs, such as those with (or a history of) major depression, bipolar disorders, schizophrenia, borderline personality disorder, post-traumatic stress disorder, substance use disorder, self-injurious behavior, psychiatric inpatient admissions, etc.
• Performs frequent home and/or other site visits (once a month or more) to assess member needs and coordinates resources, as required
• Provides and/or facilitates education to long-term care members and their families/caregivers on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, and healthcare benefits
• Provides subject matter expertise and operational support for relevant mental and behavioral health-focused activities, such as the handling of crisis calls, mental health first aid training, field safety and de-escalation practices, psychotropic and other medication monitoring, etc.
• Educates on and coordinates community resources, to include medical, behavioral and social services
• Provides coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, transportation, or activities for daily living)
• Ensures appropriate referrals based on individual member needs and supports the identification of providers, specialists, and community resources; ensures identified services are accessible to members
• Maintains accurate documentation and supports the integrity of care management activities in the electronic care management system
• Works to ensure compliance with clinical guidelines as well as current state and federal guidelines
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Comply with all policies and standards

Requirements

• Master's degree in Mental Health or Social Work, or graduate from an Accredited School of Nursing
• 2–4 years of related experience
• Texas licensure required: LCSW, LPC, LMHC, LMFT, or RN with behavioral health/psychiatric experience

Qualifications

• 3+ years of direct clinical behavioral health (post-graduate) experience in case management, care coordination, treatment planning, psychological assessments, crisis intervention, and/or discharge planning
• Direct work experience as a community or field-based Case Manager or Care Coordinator is a plus
• 3+ years of experience assessing the needs of adult members living with complex Mental Health or Serious & Persistent Mental Illness (SPMI) conditions within inpatient psychiatric hospitals or units, residential treatment centers, substance abuse rehabilitation facilities, military or veteran hospitals, or local and state MHAs
• Strong clinical documentation and problem-solving skills
• Openness, adaptability, and flexibility for business changes are critical
• Strong communication, organizational and time management skills
• Proficient user with Microsoft Office applications (MS 365 Co-Pilot, Excel, Outlook, OneNote, Word, PowerPoint, Teams)
• Working knowledge with Medicaid, STAR Plus, Medicaid Waiver, or any state and government sponsored program guidelines is a plus

Skills

• Clinical documentation
• Problem-solving
• Communication
• Organizational and time management
• Microsoft Office (MS 365 Co-Pilot, Excel, Outlook, OneNote, Word, PowerPoint, Teams)
• Medicaid, STAR Plus, Medicaid Waiver, state/government program guidelines (preferred)

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

$27.02 – $48.55 per hour. 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–Friday, 8:00 a.m.–5:00 p.m. CST
• Service delivery area near Corsicana, TX, Ennis, TX, Palmer, TX, Rice, TX, or Waxahachie, TX
• Travel for member visits is required; mileage is reimbursed