Job Family: Care Management Country: United States of America FLSA Status: United States of America (Exempt) Location: Columbia MD 21046; 6950 Columbia Gateway Drive
Provides care coordination to members with behavioral health conditions identified and assessed as requiring interventions and oversight including multiple clinical, social and community resources. This role promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member satisfaction.
Conducts in depth health risk assessment and/or comprehensive needs assessment which includes, but is not limited to psycho-social, physical, medical, behavioral, environmental, and financial parameters.
Communicates and develops the treatment plan, and serves as a point of contact to ensure services are rendered appropriately, (i.e. during transition to home care, back up plans, community based services).
Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes. Develops, documents and implements plan which provides appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs. Acts as an advocate for member's care needs by identifying and addressing gaps in care. Performs ongoing monitoring of the plan of care to evaluate effectiveness. Measures the effectiveness of interventions as identified in the members care plan.
Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes; works with members to adjust plan of care, when necessary.
Educates providers, supporting staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care. Facilitates a team approach to the coordination and cost effective delivery to quality care and services.
Facilitates a team approach to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum.
Provides assistance to members with questions and concerns regarding care, providers or delivery system.
Maintains professional relationship with external stakeholders, such as inpatient, outpatient and community resources.
Generates reports in accordance with care coordination goals.
Complies with URAC and NCQA standards for Case Management services.
Assists with orientation and mentoring of new team members as appropriate.
This position is for Columbia, MD.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled
Licensure is required; LCSW-C or LCPC or LCLMFT, and ability to meet Magellan credentialing requirements for independent professional practice (Masters level licensed behavioral health professional).
Licensure may also include one or more of the following: LCSW-C, LCSW, LMSW, LCPC, LCADC or LCMFT.
Masters degree in Mental Health required; education can be in one or more of the following areas: Social Work, Psychology, Nursing or Counseling.
Minimum 5 years post masters clinical behavioral health/psychiatric nursing experience required.
Effective application of best clinical practices.
Solid understanding of behavioral health diagnoses.
Must have proficient computer skills, including ability to converse and type at a conversational pace.
Strong organization, time management and verbal and written communication skills.
Knowledge of utilization management procedures, mental health and substance abuse community resources and providers.
Knowledge and experience in working with case management and in facilities, with local care coordinators or with special populations.
Knowledge of DSM V or most current diagnostic edition.
Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care
Education Masters: Mental Health Services (Required)
License and Certifications LCADC - Licensed Clinical Alcohol and Drug Counselor - Care Mgmt, LCMFT - Licensed Clinical Marriage and Family Therapist - Care Mgmt, LCPC - Licensed Clinical Professional Counselor - Care Mgmt, LCSW-C - Licensed Certified Social Worker - Clinical - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.