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    Case Manager Behavioral Health - Philadelphia, United States - Independence Blue Cross

    Independence Blue Cross
    Independence Blue Cross Philadelphia, United States

    3 weeks ago

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    Description

    At Independence, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

    The Behavioral Health Case Manager position functions as a primary clinical resource for members living with behavioral-health related challenges. The Behavior Health Case Manager collaboratively engages members in strengths-based approaches in order to facilitate increased understanding of each member's behavioral and physical health needs. Through this process, members gain the skills and supports to facilitate lifestyle improvement thereby enabling a holistic, person-centered approach to addressing their overall health. The Behavioral Health Case Manager provides support, guidance, and education to help members better cope with acute symptoms and make treatment decisions based on their individual preferences and needs.

    The Behavioral Health Case Manager facilitates the development of a care plan tailored to address the member's identified strengths and needs. This also includes coordination and collaboration with the member's health care team to better enhance advocacy and communication around the delivery of high quality, cost effective services including ongoing screening, assessment, treatment planning, treatment delivery and monitoring of a member's mental and physical health conditions.

    In order to maximize access to care, the Behavioral Health Case Manager teaches and guides members to better navigate the behavioral and physical health care systems, providing advocacy when needed.

    Case Managers have a strong understanding of the behavioral change process and use motivational interviewing techniques to help the member resolve any barriers to change thereby improving adherence to evidence-based, cost-effective treatment and services.

    Key Responsibilities:

    • Telephonically engages members who have a variety of behavioral health challenges to identify barriers to care related to the member's Social Determinants of Health (SDOH).
    • Engages with members to identify strengths, needs and goals, in order to facilitate development of care plans. Provides follow-up when clinically appropriate and requested by the member.
    • Serves as a liaison and support, working within the member's health care team when needed especially when members are involved in complex behavioral health situations that often warrant changes to the member's care plan.
    • Identifies and provides coaching for members to access online, telephonic and community-based resources that can assist the member in achieving and maintaining their personal behavioral and physical health goals. In addition, assist in maximizing the use of member's benefits and ensuring coordination of services and outcomes.
    • Provides appropriate clinical assessment, intervention and support to members who actively seek behavioral health support via inbound calls.
    Qualifications:

    Education
    • Active PA Registered Nurse (B.S.N. Preferred) LCSW, LSW or LPC required
    • Experience, Knowledge, & Skills
    § Minimum of 3-5 years post licensure experience in an integrated care setting, hospital or other health care setting.

    § Strong understanding of the Social Determinants of Health and Motivational Interviewing approaches to help member's move past barriers to improved behavioral and physical health outcomes.
    • Ability to work independently using critical thinking to resolve complex behavioral, medical, and psychosocial issues with our members.
    • Excellent assessment and engagement skills and ability to adapt clinical skills while using telephonic and virtual means.
    • Embraces new ideas and methods; creates and acts on new opportunities; is flexible and adaptable.
    • Ability to meet individual productivity goals in order to provide quality, cost-effective services and support to members.
    • 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.
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