Adventist Health Roseville Hiring For Health Plan Behavioral Care Manager at Roseville, CA, United States Full Time

Job Description

Adventist Health is more than an award-winning health system. We provide whole-person care to our communities and champion the greater good – from the operating room to the boardroom, we are driven by our unique passion to live God’s love through health, wholeness and hope. From Oregon to Oahu, we have a calling to always do more. Now is your chance to apply your passion to our mission.
We’re looking for someone to join our team as a Health Plan Behavioral Care Manager who:
Assumes responsibility for utilization and case management of behavioral health cases. Collaborates with other staff in co-management of more complex cases. Contributes to the Population Health Plan Initiative.
Essential Functions:

• Case manage or co-manage with the care management nurses for employees/dependents with behavioral health issues.
• Develops care plans and works with the members and their providers toward effective outcomes. Supports the proper utilization of resources.
• Performs concurrent and retrospective medical record/case review in accordance with the Care Management Program utilizing appropriate medical resources and clinical decision support tools.
• Functions as liaison to members, providers, case coordinators, discharge planners, contracted health plans/partners and internal departments. Counsels members in behaviors conducive to health. Acts as resource for our care management nurses and wellness coaches. Develops focused programs, as needed (i.e. drug seeking members).
• Assists with analytics review of claims data from varied sources relative to potential patient needs and program development. Develops programs in support of our population health initiative.
• Performs other job-related duties as assigned.

You’ll be successful with the following qualifications:
Education:

• Associate’s / Technical Degree or equivalent combination of education/related experience: Required
• Bachelor’s Degree: Preferred
• Master’s Degree in social work (LCSW): Preferred
• Doctor’s or Master’s Degree (LMFT) from an accredited school: Preferred

Work Experience:

• Five years clinical experience, including direct patient care: Preferred
• Licensed Clinical Social Worker or Licensed Psychologist: Required

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.