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4A
4004 Aetna Medicaid Administrators
Intensive Case Management Coordinator - Field- Jefferson County, KY
Career Insights for Mental / Behavioral Health Case Manager
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Based on Kentucky data
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What they do
A Mental or Behavioral Health Case Manager coordinates overall plan of care for patients with mental or behavioral health needs. Oversees patient evaluation and treatment planning and monitors patient progress. Coordinates with the rest of the mental health team, including doctors and nurses, to establish these plans.
$48,195 / year median in Kentucky
+22% projected growth
Job Description
We're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger
- helping to simplify health care one person, one family and one community at a time.
Evaluation of Members:
- Through the use of care management assessments and information/data review, recommends an approach to resolving care needs maintaining optimal health and well-being by evaluating member's benefit plan and available internal and external programs/services.
- Identifies high risk factors and service needs that may impact member outcomes and implements early and proactive support interventions.
- Coordinates and implements Wellness care plan activities and monitors member care needs.
Enhancement of Medical Appropriateness and Quality of Care:
- Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
- Identifies and escalates quality of care issues through established channels.
- Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.
- Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
- Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
- Helps member actively and knowledgably participate with their provider in healthcare decision-making.
Monitoring, Evaluation and Documentation of Care:
- Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Required Qualifications:
- Minimum of 6 months experience in Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavioral Health Services, Trauma-informed Care, ACEs (Adverse Childhood Experience), Crisis Intervention services or evidence-based practices applicable to the Kentucky SKY (Supporting Kentucky Youth) populations, is required.
- Minimum of 1 year of experience required in behavioral health, social services, social work, psychology, sociology, marriage and family therapy, or counseling.
- Minimum of 1 year of experience in Microsoft Office Suite applications, including Word and Excel.
- Willing and able to travel 80-90% of the time to meet members face-to-face in their assigned region.
- Candidate must reside in Jefferson County, KY.
Preferred Qualifications:
- 2+ years of experience in Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavioral Health Services, Trauma-informed Care, ACEs (Adverse Childhood Experience), Crisis Intervention services or evidence-based practices applicable to the Kentucky SKY (Supporting Kentucky Youth) populations
Education :
- Minimum of a Bachelor's degree or a non-licensed master level clinician is required, with either degree being in behavioral health or human services field. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $21.10
- $36.