- Completes structured clinical assessments for identified patients.
- This requires knowledge of medical terminology, diagnostic criteria, and chart review.
- Designs an individualized plan of care with the member and fosters a team approach by working collaboratively with the member, family, primary care provider, and other members of the health care team to ensure coordination of services.
- Works closely with assigned primary care provider site and functions as a case manager for patients with behavioral health co-morbidities across the care team to develop and maintain positive working relationships with patients, families and providers.
- Implements clinical interventions based on risk stratification and evidence-based clinical guidelines in conjunction with the primary care provider or specialist.
- Contacts patients through written correspondence and telephone calls, and conducts follow-up interviews.
- Provides clinical oversight and guidance to team members.
- Participates in data collection, health outcomes reporting, clinical audits and programmatic evaluation related to government initiatives.
- In partnership with the care team, identifies patients at risk for poor outcomes or experiencing poor coordination of services who would benefit from more intensive follow up.
- Provides chronic disease and self-management education and support.
- Conducts in-home member assessments for high risk and complex patient cases.
- Develops collaborative relationships with community based agencies to improve care, services and access for Health Plan membership.
- Evaluates practices of self and colleagues against standards of practice and relevant regulations and acts to improve compliance.
- Maintains required documentation for all case management activities.
- Collects required data and utilizes this data to adjust the treatment plan when indicated.
- Work Schedule: Monday through Friday from 8:00AM to 4:30PM (No weekends, on-call or holidays)
- Travel: This role is community-based and requires frequent travel throughout Monroe, Carbon and Wayne Counties.
- Preferred degree: MSW
- Required: Licensed Social Worker or Certified Rehabilitation Counselor (CRCC or NBCC) required within one year.
- KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
- EXCELLENCE: We treasure colleagues who humbly strive for excellence.
- LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
- INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
- SAFETY: We provide a safe environment for our patients and members and the Geisinger family.
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Case Manager Behavioral Health - Monroe, United States - Geisinger Health System
Description
Location:Geisinger Primary Care Mount Pocono
Shift:
Days (United States of America)
Scheduled Weekly Hours:
40
Worker Type:
Regular
Exemption Status:
Yes
Job Summary:
Serves in an expanded clinical role to collaborate with patients, Primary Care Providers, community agencies, behavioral health, and other health plan departments to provide a model of care to maximize member's health status. Integrates evidence-based clinical guidelines, preventive guidelines, protocols, and other metrics in the development of treatment plans that are patient-centric, promoting quality and efficiency in the delivery of healthcare for the Medicaid, Medicare and Commercial populations.
Job Duties:
Position Details:
Master's Degree-Social Work (Required)
Experience:
Minimum of 2 years-Clinical (Required)
Certification(s) and License(s):
Certified Rehabilitation Counselor within 1 year - CRCC or NBCC, Licensed Social Worker within 1 year - Default Issuing Body
Skills:
Computer Literacy, Critical Thinking, Organizing
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.
We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.
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