Behavioral Health Case Manager Job Description
Behavioral health case manager
provides case management services in accordance with Case Management Society of American (CMSA) Standards of Practice for members enrolled within the respective ICDS case management programs.
Behavioral Health Case Manager Duties & Responsibilities
To write an effective behavioral health case manager job description, begin by listing detailed duties, responsibilities and expectations. We have included behavioral health case manager job description templates that you can modify and use.
Sample responsibilities for this position include:
Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy, clinical criteria, and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, programs or community resources
Assess Member's physical, emotional and social needs
Formulate and coordinate plans of care
Collaborate with inpatient treatment team to prevent gaps in care and provide discharge planning support
Provide outreach in support of treatment and enhanced member self-management
Facilitate access to health information, community resources and social services
Document all interventions and telephone encounters with providers, members and vendors in the appropriate system
Function as a clinical resource for Medical Management staff
Assists with assessment/triage outpatient and concurrent review while managing the case
Provides case management and support that requires clinical expertise in various systems with focus on helping the family negotiate the complexities involved with a diagnosis
Behavioral Health Case Manager Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Behavioral Health Case Manager
List any licenses or certifications required by the position: CPR, CPI, CCM, BLS, CEU, CRRN, COHN, CDMS, ACM, AHA
Education for Behavioral Health Case Manager
Typically a job would require a certain level of education.
Employers hiring for the behavioral health case manager job most commonly would prefer for their future employee to have a relevant degree such as Master's and Bachelor's Degree in Social Work, Health, Nursing, Education, Psychology, Counseling, Graduate, Management, School of Social Work, Associates
Skills for Behavioral Health Case Manager
Desired skills for behavioral health case manager include:
Microsoft office
CRMS
InterQual
Managed care
Medicaid
Micrsoft office
Peradigm
Sidewinder and other software in order to perform job duties
Treatment modalities
Areas of case management
Desired experience for behavioral health case manager includes:
Annual certification in Non Violent Crisis Intervention (NVCI)
This position requires that you drive a facility owned vehicle or your own vehicle
Additional LAC licensure (Licensed Addiction Counselor) or 5+ years of substance abuse experience strongly preferred
Reliable transportation and auto liability
May also manage appeals for services denied
Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts
Behavioral Health Case Manager Examples
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Behavioral Health Case Manager Job Description
Job Description Example
Our growing company is searching for experienced candidates for the position of behavioral health case manager. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for behavioral health case manager
- Collaborates with providers to assess member needs for early identification of and proactive planning for discharge planning
- Will serve as key support to the BH Case Manager Ld in implementing identified operational processes/ key projects
- Uses appropriate DSM-V screening criteria, knowledge and clinical judgment to assess member needs
- Manger a caseload of 50 minimum
- Understands and supports the tenets for short term case management
- Serves as a resource to other Behavioral Case Managers
- The successful hire will be responsible for the review of Long-Term Disability (LTD) and Short-term Disability (STD) claims with complex medical conditions referred for medical assessment
- Collaborate with Rehabilitation Case Managers
- Maintains clinical records of all patient contact and clinical reviews, according to hospital policy and other regulatory guidelines (i.e., State, JCAHO)
- Attends department staff meetings (50%) and trainings relevant to position
Qualifications for behavioral health case manager
- Basic knowledge and understanding of the Case Management activities and care components of Case Management defined in the Methods and Techniques section
- Current active unrestricted license as LCSW or LPC, within the scope of licensure in state you reside in
- Current active unrestricted license as a LCSW or LPC within the scope of licensure in state you reside in
- Clinical ability to assess claims with complex medical histories which may include claimants with subjective diagnoses, co-morbid conditions
- Knowledge of Behavioral Health Case Management theory and techniques required
- Requires the ability to work as part of a dynamic, professional health care team
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Behavioral Health Case Manager Job Description
Job Description Example
Our company is growing rapidly and is searching for experienced candidates for the position of behavioral health case manager. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for behavioral health case manager
- Coordination – The case manager will organize, integrate, and modify the resources necessary to accomplish the goals established in the case management plan
- Case Manage USFHP patient population during inpatient or outpatient stays for mental health, chemical dependency and eating disorder issues
- For external USFHP referrals for psychiatry and/or therapy, provide ongoing review of outside care
- Advise patients and family members regarding benefits, resources and home management options.Assist physicians (internal and external) with management and coordination of care
- Collaborate with physicians to identify the plan of care for admission and appropriate disposition of patients from hospital, including the expected outcome(s) of patients on discharge
- Work at varied clinic and provider locations as needed
- Willingly participates in various committees, task forces, projects, and quality improvement teams, as needed and assigned
- Collaborates with clients, families and providers by assessing patient needs, facilitating and implementing clinical care, planning, education, monitoring and evaluating specific services and advocating health care needs on an individual basis either by phone
- Applies knowledge of disease continuums, expected patient outcomes and community services available
- Applies knowledge of reimbursement practices, cost analysis approaches and provider contract arrangements
Qualifications for behavioral health case manager
- Consistently demonstrates the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally sensitive service to colleagues, members, customers, contracted providers, and vendors
- Demonstrated ability to manage multiple priorities required
- Requires an understanding of and ease of use with computer, an intermediate understanding of standard database and spreadsheet software (Excel) Word Processing software (Word)
- Requires the ability to handle sensitive and confidential information
- Chronic Care Professional Certification through the Health Science Institute preferred
- Must be a licensed Registered Nurse (RN) in the state of Connecticut
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Behavioral Health Case Manager Job Description
Job Description Example
Our growing company is looking for a behavioral health case manager. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for behavioral health case manager
- Conduct Behavioral Health Assessments and update Treatment plans to reflect needed services for authorization (if licensed) or partake in Treatment planning if unlicensed
- Participate in weekly treatment team meetings to assist in the development of treatment plans with appropriate therapeutic interventions, notifies professionals of any unusual observations or incidents, client progress, and follow up
- ICM providers are expected to carry an individual case load of 20 to 30 clients
- Provide immediate, community – based support to members and providers in assigned regional settings
- Provide authorizations using the CONNECT system
- Will travel locally
- Identifies high-risk enrollees, creates care plans to address problems while maintaining quality of care
- Screens and identifies high-risk/cost, catastrophic, long term chronic cases which will benefit from care management services
- Will serve as key support to the BH Case Manager Lead in implementing identified operational processes/ key projects
- Provide case management and care coordination services for at-risk patients, including patients with complex medical, behavioral and psychosocial issues
Qualifications for behavioral health case manager
- Demonstrated strategic planning, population utilization management and the ability to integrate multiple aspects of medical center operations
- Experience in behavioral health settings that include inpatient, partial, and/or outpatient care required
- Current Ohio license required
- Ability to move between company work station
- Minimum of 3 years clinical practice experience
- Demonstrated working knowledge of QI, UM, benefit plans fiscal management, and various payment methodologies preferred
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Behavioral Health Case Manager Job Description
Job Description Example
Our innovative and growing company is looking to fill the role of behavioral health case manager. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for behavioral health case manager
- Ensure a systematic approach to the coordination of health services for patients along the care continuum in order to improve the patient experience, contain health expenditures and improve quality
- Assist members with coordinating access to appropriate care and services in an effort to improve or maintain the psychosocial, functional status and independence
- Collaborate with treatment team to develop a successful aftercare plan
- Communicates with community providers/facilities as company liaison to foster good rapport and relationships and to identify new programs
- May include coaching for Chronic Conditions and Substance Use
- Gathers pertinent clinical date on assigned patients through medical record review and communication with patient’s assigned clinical care manager, nursing staff and psychiatrist
- Provides admission and ongoing clinical reviews
- Maintains UM Documentation/Communication
- Monitors quality aspects of care on assigned patients and initiates request for “Quality Review” according to policy
- Provides for appropriate response to denials and appeals for continued stay
Qualifications for behavioral health case manager
- Position is part of the Behavioral Health Intensive Outpatient Services program and may include development and facilitation of IOP/ICMP programs, collaboration and overview of contracted programs and providers, interdisciplinary/interdepartmental collaboration within Kaiser, development and clinical review of treatment plans, and other duties as assigned
- Requires two to five years experience working in a behavioral health setting, preferably psychiatric inpatient experience
- Master’s degree in behavioral health and an unrestricted license as a LCSW, LMFT or LPC or a PhD, PsyD or RN license (with behavioral health experience)
- Current active unrestricted license as an RN, LCSW, LMHC, LPC (as allowed by applicable state laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in CA
- 3 to 4 years of direct psychiatric and/or substance abuse experience
- Experience working with electronic databases, mulitple PC's, data entry, and typing
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Behavioral Health Case Manager Job Description
Job Description Example
Our innovative and growing company is hiring for a behavioral health case manager. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for behavioral health case manager
- Builds collaborative relationships with Clinical Care Management and Tucker Intake teams to achieve optimal patient outcomes
- Adhere to clinical standards of care through collaboration with providers
- Use population-based case and disease management approaches and application of clinical protocols, which are integral to the program
- Performs care management for specialty programs in a telephonic customer- facing environment which involves utilizing a coaching approach that provides support and resources to the customers
- Assess the case management needs of high risk patients diagnosed with complex, co-occurring medical and behavioral health or substance use disorders
- Assist patients in creation and implementation of care plan goals based on health status, behavioral health issues and psychosocial needs, including lifestyle behavior change goals to improve health outcomes
- Oversee the flow of treatment information across providers and within the care team in order to maximize patients physical and emotional well-being
- Conduct Pt pre-visit planning for high risk patients and communicate patient health alerts to the care team
- Available for consultation to Care Management staff to inform and support chronic disease case management interventions to improve health outcomes
- Maintain caseload size established by the department and meet monthly productivity core service requirements
Qualifications for behavioral health case manager
- Knowledge of Psychiatry and Addiction Medicine patient populations in inpatient and outpatient settings
- Bachelor's degree required (or higher) in a health related field and licensure as a health professional where available
- Three (3) years clinical practice experience in Mental Health and or Substance Abuse
- Ability to work independently, yet collaboratively within a team structure
- Behavioral health home care experience or community mental health experience
- Incumbent must possess at least years of experience working specifically with adults with behavioral health needs to be considered for an interview