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Case Manager - Behavioral Health

Employer
UCare
Location
Minneapolis, Minnesota
Start date
Mar 1, 2019
Closing date
Mar 19, 2019

View more

Category
Healthcare, Management, Social Services
Employment Status
Full Time

Job Details

Health Care that Starts with You!

Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.

ABOUT UCARE

At UCare, we deliver high-quality health coverage and services to help members of all ages maintain and improve their health. It's a big job that takes innovative ideas, strategic partnerships, and a commitment to doing the right thing. Above all, it takes a compassionate team that is dedicated to making a real difference in the lives of our members and our communities.

WORKING AT UCARE

Working at UCare is more than just a career; it's a mission. A mission that defines us as professionals, unites us as an organization, and shapes how we interact with our members and each other. Our values of integrity, community, quality, flexibility, and respect permeate every aspect of our organization - from who we are and how we act, to what we do and how we do it. We owe our continued success to our employees who proudly embody our mission and values in everything they do.

CASE MANAGER - BEHAVIORAL HEALTH

Position Description

This position is responsible to coordinate behavioral and social services across the continuum of care to assist members as they work to address their complex health conditions and social service needs. Work directly with members to engage, assess, develop, implement, coordinate, monitor and evaluate care plans for identified needs.  Refer as needed and collaborate with providers, county and community agencies to coordinate the provision of services for UCare members.

·Provide telephonic case management for members with behavioral health conditions. 

·Engage members in ongoing care management using evidence-based practices including Motivational Interviewing and Trauma Informed Care.

·Conduct assessments to identify individual needs including addressing social determinant of health needs and actively linking members to appropriate resources available in their community.

·Collaborate with members and/or family members, behavioral clinicians, psychiatrists, primary care providers, clinic staff and other relevant agencies in the continuum of care to assure appropriateness of service that meets member needs and supports desired outcomes.

·Develop and implement care plan, in collaboration with member/family/caregiver that is appropriate to the member's needs. Monitors and evaluates effectiveness of the care plan and modifies as necessary.

·Identify and monitor member needs, including needed preventive care, and significant change in condition which may warrant early intervention or transition of care. Incorporate culturally appropriate approaches to care planning, as needed.

·Enter member information in the Care Management software.  Documentation is accurate, thorough and timely.

·Meet and maintain all established caseload and performance metrics.

·Actively participate in management of care transitions across the continuum of care to ensure associated planning addresses health care needs and appropriate use of resources.

·Provide information to members and providers regarding behavioral health benefits, services and resources.

·Understand and accurately interpret and apply relevant contractual requirements, policies, procedures and regulations for those members for which case management is a provided service.

·Collaborate with multidisciplinary staff to bring perspective based on your discipline and experience. 

·Complete the continuum of utilization review processes within the established department turnaround times.  This includes:  initiate and complete first level medical necessity review; issue organization determination notifications including approvals, denials, terminations, and reductions; and routing service requests to the behavioral health medical director for physician review.

·Provide consistent and sound first level medical necessity review for published authorization strategies, medical policies, review criteria, review standards, and regulatory requirements in the application of the utilization review process.

·Review initial and concurrent requests for inpatient and residential admissions and continued stay. Facilitate discharge planning with hospital and UCare or delegate case managers.

·Adhere and understand the interplay regulatory requirements and policies as it relates to behavioral health services and utilization review. Apply, interpret and communicate policies, procedures, clinical guidelines, medical policy, regulations and standards.

·Other projects and duties as assigned.

Education

RN, Licensed Psychologist, or LICSW with requisite experience.  Current and unrestricted Minnesota license required.

Required Experience

RN candidate with experience working with Medicaid/Medicare populations and one of the following:

•2 years in outpatient mental health or substance use treatment facility

•2 years as staff in an inpatient mental health unit, crisis residential, IRTS, or crisis residential facility.

•A minimum of two years direct behavioral health clinical experience.

LP or LICSW candidate with experience working with Medicaid/Medicare populations with the following:

•3 to 5 years' experience in psychiatric and/or substance abuse treatment. Experience in settings that include inpatient, partial, and/or outpatient treatment and care management services in a behavioral care management organization preferred

Preferred Experience

RN, LP or LICSW candidate with 2 years' experience in utilization review and/or case management. Dually licensed as LADC. Knowledge of utilization review standards and experience working with state and federally funded programs. Experience in an HMO or MCO highly desirable.

THE UCARE DIFFERENCE

UCare is proud to be a recognized Star Tribune Top Workplace for the 9th consecutive year. As a part of our collaborative team, you'll experience the rewards that come with helping others and seeing the positive results of your hard work. We value and respect each individual's ideas and contributions, and give you the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, a myriad of volunteer activities, and a number of other rewards. If you're looking for a welcoming environment that celebrates what you have to offer, helps you build on your strengths, and gives you the opportunity to truly make a difference, we invite you to apply.

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

 

 


Rewards

Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers. At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
www.ucare.org/careers/
EOE/AA

Company

UCare offers Medicare, Medicaid, Individual and Family health plans – powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives. 

WORKING AT UCARE

Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job. 

Our strong culture has established UCare as a Star Tribune Top Workplace for 12 consecutive years since the awards program began. It’s a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities. 

THE UCARE DIFFERENCE

The UCare difference is our people power – employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.  

Company info
Website
Telephone
612-676-6500
Location
500 Stinson Blvd.
Minneapolis
Minnesota
55413
US

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