About the job
Are you a passionate and skilled Behavioral Health Case Manager seeking an exciting new role with a leading healthcare organization? If you're eager to elevate your career within a dynamic and expanding company, this opportunity is tailored for you!
Key Responsibilities:
- Oversee daily operations of Integrated Case Management functions, focusing on high-risk members to assess their needs and goals, fostering empowerment and enhancing the quality of life in both behavioral and physical health domains.
- Evaluate the current functional status of members and collaboratively develop and oversee their Case Management Care Plan, ensuring quality of care, assisting with discharge planning, and engaging in specialized clinical projects while maintaining communication with departmental and plan administrative staff.
- Partner with medical and behavioral health providers to guarantee optimal care for members.
- Engage telephonically with high-risk patients and their healthcare providers to identify needs, establish goals, and implement actionable steps to achieve these goals.
- Empower patients to enhance their quality of life through a holistic and integrated approach to complex issues.
- Adhere to NCQA guidelines and HEDIS measures.
- Follow established referral, pre-certification, and authorization protocols as dictated by the Medical Management team.
Work Hours:
Monday - Friday, 8 AM - 5 PM

