Intensive Case Manager

  • Alameda, CA
  • Full-time

Company Description

Beacon Health Strategies is a company of industry-leading behavioral health experts, managed and advised by nationally recognized medical, behavioral, human services, and pharmacy clinicians.

In close partnership with health plans, we help bring together the fragmented pieces of healthcare to achieve better results for the people in our care. Our programs are clinically driven, fiscally responsible, and focused on continually improving outcomes for the most complex members.

Beacon’s objective is to be the single best source of clinical excellence and cost containment for the most complex, most co-morbid individuals in any covered population.

Job Description

Responsible for
triaging, assessing, and managing of members referred to Case Management.
Responsible for the tracking and managing of members identified as Intensive
Case Management (ICM) who may be high risk, high utilizing, at significant
clinical risk or under-utilizing services.

Qualifications

A staff providing Case Management services will have at least one of the following:

  • Master’s degree or higher in a health related field and licensure as a behavioral health professional. Current, valid and unrestricted licensure for independent practice required, as LICSW, LMFT, or RN
  • BSN, licensure as a professional and 3 years behavioral health clinical practice
  • Licensed behavioral health clinician/nurse who has Certification as a Case Manager is preferred

 

Case Managers must practice within the scope of their license (see Scope of Licensure statement).  Non-certifications may not be issued on initial review, and always require consultation with a Physician or Psychologist Advisor

Case Managers are required to be educated in
current principles, procedures and knowledge domains of case management based on
nationally recognized standards of case management and must be a licensed
behavioral health clinician. Re-verification to occur at a minimum of every 3
years.

Additional Information

Responsibilities:

 

-Identification of all assigned ICM Members

-Independent assessment of members enrolled in ICM.

-Managing, coordinating care, tracking and reporting of all assigned ICM Members

-Collaboration with  Community Support Programs (CSP)

-Utilization Review for designated ICM Clients around/outside of Massachusetts only for diversionary levels of care

-Phone coverage as needed on the Urgents Line and for Member Services calls

-Assist in collection of outcomes information, annual analysis and other reporting and initiatives

-Telephonic collaboration and coordination with  provider and state agencies regarding ICM members and systems meetings as needed

-Assist with NCQA and URAC initiatives

-Urgent calls

-Telephonic collaboration with Members

-Treatment Record Reviews

-Attend Clinical meetings

-Utilization Review of non-ICM members as needed

-Other duties as assigned