Case Manager Behavioral Health - Triage (remote) 10:45a-7p shift

Shift: 10:45a-7p (full-time, M-F)

Bring your drive for excellence, team orientation and customer commitment to Independence Blue Cross; help us renew and reimagine our business and shape the future of health care.  Our organization is looking to diversify, grow, innovate and serve, and we are looking for committed, empowered learning-oriented people to join our team.  If this describes you, we want to speak with you.

Job Summary:

Behavioral Health Triage Case Manager position works with at- risk members to facilitate clinically appropriate linkages to care.   Triage Case Managers collaborate on care plan development and coordination with members and members health care team including physicians by screening, assessing, planning, facilitating, monitoring and giving input when adjustment is needed, and advocating for the member on an individual basis.  Case Managers use clinical and motivational interviewing skills to assess member’s need including crisis intervention to navigate and connect members to timely and effective services.  Triage Case Managers work with the member to identify and address barriers to member’s adherence to standards of evidence -based medicine.   The case manager facilitates communication between the patient, family, and members of the health care team while acting as an educator and link between the patient, providers and the plan, ensuring high quality, cost-effective services are delivered.  Helps members coordinate care and navigate the healthcare system. 

Key Responsibilities:

• Provides telephone triage, crisis intervention and care navigation for at-risk members with mental health and/or substance use concerns
• Demonstrates the ability to engage with members, and families, effectively assessing needs; providing evidence informed information, resources, and navigation to promote accurate and timely access to appropriate behavioral health services
• Skillfully deescalates callers, provides brief supportive counseling and takes action in crisis situations. Manages high risk interactions to ensure the appropriate level of support and intervention is provided in an efficient manner.

• Matches members with appropriate behavioral health and substance use providers based on clinical assessment and access needs, follows processes to ensure members are connected to care
• Proactively incorporates lifestyle improvement and prevention opportunities into member interactions and coaching.
• Contacts members physician/health care provider when needed especially in more complex behavioral health situations requiring case management intervention to facilitate care coordination and potential care plan changes.
•  Identifies on-line, telephonic and community- based resources that can assist the member in achieving and maintaining their personal health goals. Assist the member in accessing those services.  In addition, assist in maximizing the use of member’s benefits and ensuring coordination of services and outcomes.

Qualifications - Internal

Qualifications:

Education/Licensure: 

• Active PA Registered Nurse License required.  B.S.N. or LSW, LCSW, LPC 

Experience, Knowledge, & Skills

• Minimum of three to five years post licensure in behavioral health clinical experience in a hospital or other health care setting including training in crisis intervention and suicide prevention.
• Previous experience preferred in Utilization Review or Case Management, Care Navigation
• Knowledge of DSM 5 and ASAM
• Ability to work independently using critical thinking to resolve complex behavioral, medical, and psychosocial issues for our members.
• Ability to adapt clinical assessment skills to telephonic assessment and follow-up.
• Comfortable with new ideas and methods; creates and acts on new opportunities; is flexible and adaptable.
• Exceptional problem-solving and organizational skills required.
• Works to build relationships and provides exceptional customer service.
• Able to work effectively as part of a team.
• Highly professional interpersonal skills.
• Strong computer skills and experience with Microsoft Office Suite.