Care Manager - DUR
7 months ago
Durham
Job DescriptionJob Summary:We are seeking a highly skilled and compassionate Behavioral Health Manager to join our team. To perform this job successfully, an individual must be able to perform the essential job functions satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the primary job functions herein described. Since every duty associated with this position may not be described herein, employees may be required to perform duties not specifically spelled out in the job description, but which may be reasonably considered to be incidental in the performing of their duties. Duties: Care Management Services: • Actively engages with individuals receiving care management services through assessment, care coordination, health promotion, and comprehensive transitional care/follow up., • Makes appropriate referrals to community resources and empowers individuals to be responsible for their own healthcare and personal needs., • Coordinates follow-up services for individuals with recent inpatient hospitalization or Emergency Department visit within 24 hours of discharge., • Identifies and provides emergency crisis response as necessary and following agency policies related to crisis. Participation in agency on-call structure may be required and in 24:7 crisis response for members., • Communicates effectively with individuals receiving services, providers, and other natural support as needed. Provide education regarding services to all parties involved in the care and support of the individual., • Maintain medical record compliance/quality., • Review data to identify and determine appropriateness for services, which includes monitoring utilization, reporting, clinical measurement data and compliance issues., • Demonstrate knowledge of and comply with all agency policies and procedures, as well as service definitions related to specific program areas. Maintain trainings as required and requested., • Participates in Quality Improvement (QI) projects, to improve service deliver, costs of care, on an as needed basis., • A bachelor’s degree in a field related to health, psychology, sociology, social work, nursing or another relevant human services area, or licensure as a registered nurse (RN)., • Two years of experience working directly with individuals with behavioral health conditions (if serving members with behavioral health needs)., • Knowledge of ICD-10 coding system, • Strong understanding of behavior management techniques, • Excellent communication and interpersonal skills, • Ability to work effectively in a team environment