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Case Manager I

Integrated Resources, Inc

Albuquerque, NM(remote)

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JOB DETAILS
SKILLS
Behavioral Health, Calendar Management, Case Management, Clinical Competency, Clinical Study Publications, Communication Skills, Documentation, Emergency Care, Healthcare, Healthcare Effectiveness Data and Information Set (HEDIS), Healthcare Management, Healthcare Providers, Healthcare Quality, Leadership, Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Mental Health Counselor (LMHC), Maintain Compliance, Microsoft Internet Explorer Browser, Plan Meetings, Privacy Controls, Product/Service Launch, Psychiatry and Mental Health, Regulatory Compliance, Social Work, Substance Abuse Treatment, Team Player, Willing to Travel
LOCATION
Albuquerque, NM
POSTED
30+ days ago
Job Title: Case Manager I
Location: Remote + Field Visit (Albuquerque or Las Cruces)
Duration: 3 Months+ (Possible Extension)

Schedule: 8 Am – 5 Pm Mon - Fri (MST)
 
Travel: there will be travel associated. The candidate chosen would be expected to travel to member residences, community-based agencies within city/county limits and potential for surrounding counties within the catchment area to engage. 

 

Job Description:
Is this a temp to hire position? It could be in the future but not right now.
 
Required Licensure / Education:
  • The care management personnel must hold one of the licenses (or relevant state equivalent) below to participate in the initiative:
  • Clinical Social Workers (ex. LCSW, LISCW)
  • Professional Counsellors/Licensed Mental Health Counsellors (ex. LPC/LPCC, LMHC)
  • Marriage and Family Therapists (LMFT)
  • Certified Alcohol and Drug Counsellor (CADC)
  • Substance Use Disorder Professional (SUDP)
  • These staff should have unrestricted license in the state in which they are working as a care manager and a National Provider Identifier.
 
Required Years of Experience : 3 years
  • The utilization of specific care management staff to conduct visits (telephonic or face-to-face to satisfy the requirements of multiple Behavioral health follow-up measures (FUH, FUM, FUI, and IET).
  • Measures In Product:
  • FUH - Follow up After Hospitalization for Mental Illness
  • FUM - Follow up After Emergency Department Visit for Mental Illness
  • FUI - Follow up After High Intensity Care for Substance Disorder
  • IET-Initiation and Engagement of Alcohol and other Drug Abuse or Dependence Treatment
 
Must have skills:
  • Active, unrestricted Behavioral health clinical license in the state of practice (LCSW/LISW, LPC/LPCC/LMHC, LMFT, CADC, SUDP, or state equivalent) · National Provider Identifier (NPI) required
  • Minimum of 3 years of experience in Behavioral health, substance use disorder treatment, care management, or a related clinical setting
  • Demonstrated Behavioral health care management experience, including transitional support following hospitalizations or emergency department visits.
  • Strong working knowledge of Behavioral health quality and HEDIS measures, including FUH, FUM, FUI, and IE
  • Proven ability to conduct telephonic and/or face-to-face outreach with members to support follow-up care · Experience scheduling and coordinating appointments with Behavioral health providers or internal care teams. Ability to utilize established care management programs to provide ongoing member support
  • Excellent clinical documentation skills, with the ability to accurately document member interactions in accordance with job aides and compliance requirements.
  • Strong communication and collaboration skills, including the ability to work with leadership and interdisciplinary teams
  • Demonstrated ability to handle and protect PHI in compliance with healthcare privacy and security standards
 
Day to Day Responsibilities:
  • CM staff responsibilities include Reaching out to members identified for transitional support.
  • Scheduling appointments with members’ Behavioral health treatment providers or Care Connections.
  • Utilizing existing care management programs to provide ongoing member support.
  • Documenting all member interactions, ensuring compliance with the job aide to contribute to HEDIS goals.
  • Communicating with local leadership regarding any questions or concerns about the procedures.

About the Company

I

Integrated Resources, Inc

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