Case Manager Behavioral Health - LCPC LCSW

A-Line Staffing Solutions

Job Description

Behavioral Health Care Coordinator (LCPC OR LCSW) openings with a major health insurance / managed care company based in the Chicago, IL! Starting ASAP!! Apply now with Luke H. at A-Line!

**Position will start remote/WFH; but eventually plans to return to working in the field, may require 1x per month travel (no overnights) – hoping for Fall 2021**

POSITION PURPOSE: Conducts comprehensive member psychosocial assessments through root cause analysis and performs clinical intervention through the development of a care management treatment plan specific to each member with high level acuity needs. Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability. Assess members to recommend activities and behavioral routines to meet the social and medical needs of members and their families. Provides support and/or intervention and assists members in understanding the implications and complexities of their current medical situation and/or overall personal care.

SCHEDULE: Monday-Friday, 8am - 4:30pm

PAY RATE: $35 - $45 per hour (determined on experience)

DAILY RESPONSIBILITIES:

  • Assesses, plans, implements, monitors and evaluates options and services to meet complex psychosocial health needs of inpatient and outpatient members.
  • Manages a caseload in compliance with contractual obligations and company standards.
  • Conducts comprehensive member assessments through root cause analysis based on referred member's needs and benefit plan eligibility, and performs clinical intervention through the development of a care management treatment plan specific to each member with high level acuity needs.
  • Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability.
  • Works towards achievement of optimal clinical and resource outcomes.
  • Monitors and evaluates effectiveness of care plan and modifies plan as needed.
  • Supports member access to appropriate quality and cost-effective care.
  • Coordinates with internal and external resources to meet identified needs of the member's care plan and collaborates with providers.
  • Acts as a liaison and member advocate between the member/family, physician and facilities/agencies.
  • Provides clinical consultation to physicians, professional staff and other teams members/supervisors to provide optimal quality patient care and effective operations.
  • Interacts continuously with members, family, physician(s), and other resources to determine appropriate behavioral action needed to address medical needs.
  • Reviews benefits options, researches community resources, trains/creates behavioral routines and enables members to be active participants in their own healthcare.
  • Ensures members are engaging with their PCP to complete their care management treatment plan or preventive care services.
  • Assists in obtaining benefits for members through community resources when benefits are exhausted or not available.

JOB REQUIREMENTS:

  • 2+ years of experience in behavioral health management and/or acute behavioral health care setting focusing on outpatient/inpatient utilization, case management and discharge planning
  • 1+ year of experience in current case management as a licensed professional
  • Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
  • Experience working with Data mining
  • Software Skills Required: Microsoft suite; patient charting and care planning
  • Must either be a Licensed Clinical Professional Counselor (LCPC) -OR- a Licensed Clinical Social Worker (LCSW)
  • Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position

PREFERRED EXPERIENCE:

  • 2+ years of and knowledge of healthcare and managed care preferred.
  • Experience in a managed care environment
  • Long Term care background
  • Field experience

WHY APPLY:

  • Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability
  • 401k after 1 year of employment: With employer match and profit sharing
  • GREAT Hours! Monday through Friday, 40 hours per week
  • Competitive Pay Rate!

Keywords: LCSW, LCPC, RN, Registered Nurse, Behavioral Health, Mental Health, Provider Services, Counseling, Crisis Counselor, Credentialing, DSM, Medical Coding, Medical Billing, Concurrent Review, Denials, Grievance, Grievance and Appeals, Appeals and Denials, Utilization Review, Case Management, Medicare-Medicaid Alignment Initiative, MMAI, CCM, Case Manager, URAC, HEDIS, STARS, InterQual, CMS, Medicare, Medicaid, Utilization Management, Telephonic, PBM, Claims, Rx, Certified Case Manager, Care Coordination, Health Plan, Health Insurance, MCO, Managed Care, Medical Claims, Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Patient Counselor, Healthcare.

Job Requirements

JOB REQUIREMENTS:

  • 2+ years of experience in behavioral health management and/or acute behavioral health care setting focusing on outpatient/inpatient utilization, case management and discharge planning
  • 1+ year of experience in current case management as a licensed professional
  • Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
  • Experience working with Data mining
  • Software Skills Required: Microsoft suite; patient charting and care planning
  • Must either be a Licensed Clinical Professional Counselor (LCPC) -OR- a Licensed Clinical Social Worker (LCSW)
  • Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position

PREFERRED EXPERIENCE:

  • 2+ years of and knowledge of healthcare and managed care preferred.
  • Experience in a managed care environment
  • Long Term care background
  • Field experience


Keywords: LCSW, LCPC, RN, Registered Nurse, Behavioral Health, Mental Health, Provider Services, Counseling, Crisis Counselor, Credentialing, DSM, Medical Coding, Medical Billing, Concurrent Review, Denials, Grievance, Grievance and Appeals, Appeals and Denials, Utilization Review, Case Management, Medicare-Medicaid Alignment Initiative, MMAI, CCM, Case Manager, URAC, HEDIS, STARS, InterQual, CMS, Medicare, Medicaid, Utilization Management, Telephonic, PBM, Claims, Rx, Certified Case Manager, Care Coordination, Health Plan, Health Insurance, MCO, Managed Care, Medical Claims, Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Patient Counselor, Healthcare.

Apply