Care Manager

Axelon Services Corporation

OH

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JOB DETAILS

JOB TYPE

Full-time

SKILLS

Acute Care, Behavioral Health, Health Plan, Health Plan Membership, Healthcare Providers, Leadership, Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Mental Health Counselor (LMHC), Maintain Compliance, Medical Treatment, Member Orientation, Needs Assessment, Nursing Credentials, Pediatrics, Quality Management, Registered Nurse (RN), Regulations, Side Effects, Social Work, Third-Party Payer, Time Management, Training/Teaching, Willing to Travel

LOCATION

POSTED

2 days ago

Responsibilities: Evaluate the needs of members via phone or in-home visits to recommend and facilitate care plans, including behavioral health and social determinant needs. Perform telephonic, digital, home, and/or other site visits to assess member needs and collaborate with resources. Develop ongoing care plans for members with high acuity and identify needed providers, specialists, and community resources. Coordinate between members, family/caregivers, community resources, and the care provider team to ensure accessible services. Monitor care plans/service plans and member status for changes in treatment side effects, complications, and clinical symptoms, providing recommendations based on identified needs. Facilitate care coordination and collaborate with appropriate providers or specialists for timely access to needed care or services. Collect, document, and maintain member information and care management activities to ensure compliance with state, federal, and third-party payer regulations. Provide education to members and families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, including behavioral health and social determinant needs. Provide feedback to leadership on opportunities to improve care and quality delivery for members in a cost-effective manner. Comply with all policies and standards. Requirements: Master's degree in Behavioral Health or Social Work, or a degree from an Accredited School of Nursing. 2 – 4 years of related experience. Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN with BH experience required. For Illinois Youth Care plan: Graduate degree and independently licensed behavioral health clinician (e.g., LCSW, LCPC, PsyD) in Illinois or Bachelor's Degree and IL RN licensure. Must reside in IL. For NJ Health Plan: Master's degree in Behavioral Health or Social Work and a Licensed Associate Counselor (LAC) or Licensed Social Worker (LSW) required. For Sunshine Health (FL): Master's degree in social work or related field and one year of related professional pediatric care experience. May require up to 80% local travel. AXEL01

About the Company

Axelon Services Corporation

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