OR - Behavioral Health Care Manager - - Tekfortune Inc.
Corvallis, OR 97330
About the Job
Job Description:
This is a hybrid position in which people would need to reside somewhat locally to Corvallis, OR or would need to relocate. The hybrid piece is primarily remote and onsite presence in the office, member homes, or a clinic. This is a non leadership role,
JOB SUMMARY/PURPOSE
Assesses, plans, implements, coordinates, monitors and evaluates options and services to meet an individual s behavioral health needs. Applies knowledge of applicable regulations, identifies resources (internal or community partners) and eliminates barriers where possible. Provides care management interventions and seamless support across transitions of care. Works with cases that have a low to moderate level of service intensity.
DEPARTMENT DESCRIPTION
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services mission of Building Healthier Communities Together.
EXPERIENCE/EDUCATION/QUALIFICATIONS
Master's degree in Mental Health, Social Work, Clinical Psychology or a closely related field required.
Current unencumbered Oregon credential/licensure in one (1) of the following required:
Licensed Clinical Social Worker (LCSW).
Licensed Professional Counselor (LPC).
Licensed Psychologist (PhD or PsyD).
Clinical Social Work Associate (CSWA).
Licensed Master of Social Work (LMSW).
Licensed Marriage and Family Therapist (LMFT).
One (1) year clinical experience required.
Experience or training in the following required:
Health care delivery systems and/or managed care patients.
Computer applications including electronic documentation (e.g., MS Office, EPIC, Clinical Care Advanced).
Experience in the following preferred:
Case management.
Medicare and Medicaid rules and regulations and health plan benefit structure and policy.
KNOWLEDGE/SKILLS/ABILITIES
Communication - Effective written and verbal communication skills provided to members, providers and organization staff. Able to tactfully discuss issues, and listen to and understand complex information/situations. Ability to apply motivational interview techniques when working with members. Proactively resolve conflicts in positive and constructive manner.
Confidentiality - Knowledge of State and Federal (HIPAA) laws pertaining to confidentiality of protected health information. Ability to comply with laws and maintain confidentiality of patient information.
Critical Thinking - Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions in a member centric manner.
Social Perceptiveness - Ability to work with a diverse population from pediatrics to geriatrics. Basic understanding of age-related differences in caring for and/or communicating with members and caregivers. Possess personal sensitivity to the needs and experiences of others and a non-judgmental attitude towards persons of differing standards, values, lifestyles, and ages.
Knowledge of Medicare and Medicaid rules and regulations and health plan benefit structure and policy. Ability to appropriately apply evidence based clinical practice and criteria to authorization requests.
Position Urgency:
Normal
Shifts:
Days, Full Time
State License Details:
Upon Acceptance
Minimum Years of Experience:
1
Specialty Type:
Behavioral Health
Sub Specialty:
Clinical Social Worker
Bilingual:
No
Holiday Coverage Required:
No
This is a hybrid position in which people would need to reside somewhat locally to Corvallis, OR or would need to relocate. The hybrid piece is primarily remote and onsite presence in the office, member homes, or a clinic. This is a non leadership role,
JOB SUMMARY/PURPOSE
Assesses, plans, implements, coordinates, monitors and evaluates options and services to meet an individual s behavioral health needs. Applies knowledge of applicable regulations, identifies resources (internal or community partners) and eliminates barriers where possible. Provides care management interventions and seamless support across transitions of care. Works with cases that have a low to moderate level of service intensity.
DEPARTMENT DESCRIPTION
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services mission of Building Healthier Communities Together.
EXPERIENCE/EDUCATION/QUALIFICATIONS
Master's degree in Mental Health, Social Work, Clinical Psychology or a closely related field required.
Current unencumbered Oregon credential/licensure in one (1) of the following required:
Licensed Clinical Social Worker (LCSW).
Licensed Professional Counselor (LPC).
Licensed Psychologist (PhD or PsyD).
Clinical Social Work Associate (CSWA).
Licensed Master of Social Work (LMSW).
Licensed Marriage and Family Therapist (LMFT).
One (1) year clinical experience required.
Experience or training in the following required:
Health care delivery systems and/or managed care patients.
Computer applications including electronic documentation (e.g., MS Office, EPIC, Clinical Care Advanced).
Experience in the following preferred:
Case management.
Medicare and Medicaid rules and regulations and health plan benefit structure and policy.
KNOWLEDGE/SKILLS/ABILITIES
Communication - Effective written and verbal communication skills provided to members, providers and organization staff. Able to tactfully discuss issues, and listen to and understand complex information/situations. Ability to apply motivational interview techniques when working with members. Proactively resolve conflicts in positive and constructive manner.
Confidentiality - Knowledge of State and Federal (HIPAA) laws pertaining to confidentiality of protected health information. Ability to comply with laws and maintain confidentiality of patient information.
Critical Thinking - Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions in a member centric manner.
Social Perceptiveness - Ability to work with a diverse population from pediatrics to geriatrics. Basic understanding of age-related differences in caring for and/or communicating with members and caregivers. Possess personal sensitivity to the needs and experiences of others and a non-judgmental attitude towards persons of differing standards, values, lifestyles, and ages.
Knowledge of Medicare and Medicaid rules and regulations and health plan benefit structure and policy. Ability to appropriately apply evidence based clinical practice and criteria to authorization requests.
Position Urgency:
Normal
Shifts:
Days, Full Time
State License Details:
Upon Acceptance
Minimum Years of Experience:
1
Specialty Type:
Behavioral Health
Sub Specialty:
Clinical Social Worker
Bilingual:
No
Holiday Coverage Required:
No
Source : Tekfortune Inc.