Clinical Care Manager

Description:

POSITION SUMMARY:

The Clinical Care Manager performs various clinical tasks supporting the utilization management function of Advanced Behavioral Health, specifically related to the performance of the Behavioral Health Recovery Program (BHRP). This position will represent ABH® and its services in a positive and professional manner and adhere to ABH®’s best practices, guidelines, policies and procedures as established, promoting ABH® as a leader in behavioral healthcare in all interactions and work.

DUTIES AND RESPONSIBILITIES:

  • Performs clinical review of behavioral health cases including, but not limited to, maintaining familiarity and understanding of contract requirements related to the daily performance of clinical activities; provide telephone (ACD) coverage for incoming telephone calls to the clinical line for pre-certification, information and referral calls. Hours of coverage and call volume are assigned by the Clinical Team Leader and are determined by business needs;
  • Perform case review for assigned providers, meeting all contract performance standards; case review to be performed in a manner that seeks to build collaborative relationships with the provider community;
  • Identifies clients who could potentially benefit from services provided by the Intensive Case Management Program including clients who are classified as “high utilizers”, clients identified as meeting criteria for participation in OATP or MH IV.2 treatment protocols, or any clients more likely to need community-based supports. 
  • Document fully and appropriately all clinical data collected during the review process, meeting all contract performance standards for documentation.  This documentation should include, but not be limited to, Pre-/Post-Admission, Continued Stay, Discharge and Informational Reviews;
  • Perform telephonic reviews for any cases identified as exceeding length of stay thresholds to facilitate timely transition to a less intensive level of care;
  • Identify quality concerns related to providers in the Care Manager’s assigned region and notify the Clinical Team Leader.  As necessary, participate in targeted technical assistance and training for providers in collaboration with the Clinical Team Leader;
  • Maintains confidentiality of all client protected health information and adheres to all HIPAA related reviews, goal setting, etc;
  • Demonstrates ethical behavior and cultural sensitivity in all activities involving individuals of diverse backgrounds;
  • Performs other tasks/responsibilities as required to support the business operations.

EDUCATION AND EXPERIENCE REQUIREMENTS:

  • Master’s degree with licensure in appropriate field required;
  • 5+ years of demonstrated work experience in mental health or addiction treatment field;
  • Active State of Connecticut professional license (RN, LCSW, LMFT or LPC) required;
  • Mental health or addiction treatment professionals with current, active State of Connecticut professional license.  Examples include Registered Nurses (RN), Licensed Clinical Social Workers (LCSW), Licenses Marriage/Family Therapist (LMFT), or Licensed Professional Counselor (LPC);
  • Attends annual conflict of interest training.

KNOWLEDGE/SKILLS/ABILITIES:

  • Flexibility in order to respond quickly and positively to shifting demands and changing management opportunities;
  • Capability of traveling to provider sites as needed to provide technical support and assistance related to utilization management functions;
  • Strong attention to detail; ability to work on multiple tasks and meet deadlines;
  • Excellent PC skills with demonstrated experience using Microsoft Office Package (MS Word, Excel, Power Point, Access, Outlook); internet;
  • Strong written and verbal communication skills required.

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We are an Equal Opportunity Employer.


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Advanced Behavioral Health, Inc.

213 Court Street
Middletown, CT 06457

Phone: (860) 638-5309
Fax: (860) 638-5302