Clinical Care Manager II (full-time)

Clinical Care Manager II - Idaho

General Position Summary:

This full-time position is responsible for providing utilization review activities and clinical peer reviews for all levels of behavioral health care; clinical assessment, placement and continued stay reviews; completing mental health reviews and determining need for further assessment; collecting and analyzing utilization data; intensive case management. This position also assists with answering crisis phone calls; provides customer support to clients, providers and stakeholders; and participates in quality improvement projects.

Essential Functions:

· Conduct clinical assessments.

· Conduct clinical placement and continued stay reviews.

· Conduct clinical peer reviews.

· Coordinate community based mental health assessments.

· Provide Intensive Case Management services as assigned.

· Crisis phone call response.

Secondary Functions:

· Communicate and advise clients, provider network, and stakeholders regarding behavioral health benefits, utilization management function, community treatment resources, and BPA Health policies, procedures, and criteria.

· Participate in quality improvement activities, including peer audits and data collection, tracking and analysis.

· Advocate for the client to ensure treatment needs are met. Propose alternative plans of treatment when requests for services do not meet medical necessity criteria.

· Provide appropriate referrals as needed.

· Perform other duties as assigned.

Supervisory Responsibility:

None

Education and/or Experience:

· Master's degree in behavioral health field (i.e., counseling, social work)

· Unrestricted Idaho clinical licensure in behavioral health (LPC, LCPC, LCSW or LMFT required)

· Proficient with MS Office, including Word, Excel, PowerPoint and Outlook.

· Pass a criminal history background check and drug screen.

Specific Job Skills and Competencies:

· Excellent customer service skills.

· Strong interpersonal, oral and written communication, organizational, analytical, time management, and computer skills.

· Knowledge of utilization management procedures and behavioral health community resources and providers.

· Crisis intervention skills.

· Ability to exercise sound judgment, make logical decisions and to perform independently and as a team member.

· Knowledge of DSM 5 and ASAM criteria.

· Ability to audit clinical review criteria, analyzes specific utilization problems, plan and implement solutions that directly influence quality of care.

· Strong initiative and creative problem-solving abilities.

· Appreciation of cultural diversity and strong sensitivity towards target member population.

· Detail oriented and accurate with the ability to manage multiple projects at one time.

· Adherence to the values and mission of BPA Health

· Must be reliable, punctual, and flexible.

Travel Requirements:

Limited travel, up to 10% may be required. Ability to make trips involving overnight stays. Means of transportation required.

Physical Requirements:

While performing the duties of this job, the employee is continuously required to read, talk and hear. The employee is continuously required to walk, sit or stand at a computer workstation, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

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Full Time