JOB DESCRIPTION
Provides support for care management/care coordination activities and
collaborates with multidisciplinary team coordinating integrated delivery of
member care across the continuum. Strives to ensure member progress toward
desired outcomes and contributes to overarching strategy to provide quality and
cost-effective member care.
This position will support our ED Diversion Behavioral Health Care Management
program. The ideal candidate will bring strong expertise in behavioral health
conditions and substance use disorders, with experience engaging high-acuity
members who frequently utilize emergency services. Preferred qualifications
include knowledge of crisis stabilization services, ED workflows, mobile crisis
teams, and community-based behavioral health resources.
Schedule 8:30am-5:00pm M-F.
Essential Job Duties
• Completes comprehensive behavioral health assessments of members per regulated
timelines and determines who may qualify for care coordination/case management
based on clinical judgment, changes in member health or psychosocial wellness
and triggers identified in assessments.
• Develops and implements care plan in collaboration with member, caregiver,
physician and/or other appropriate healthcare professionals and member support
network to address member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document
interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health,
long-term services and supports (LTSS), and home and community resources to
enhance continuity of care.
• Facilitates interdisciplinary care team meetings and informal ICT
collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate,
support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to
member to address concerns.
• May provide consultation, resources and recommendations to peers as needed.
• 25-40% estimated local travel may be required (based upon state/contractual
requirements).
Required Qualifications
• At least 2 years health care experience, preferably in behavioral health, or
equivalent combination of relevant education and experience.
• Licensed behavioral health clinician to include: Licensed Clinical Social
Worker (LCSW), Licensed Master Social Worker (LMSW), Advanced Practice Social
Worker (APSW), Certified Health Education Specialist (CHES), Licensed
Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC),
Licensed Marriage and Family Therapist (LMFT, Doctor of Psychology (PhD or PsyD)
or equivalency based on state contract, regulation, or state board licensing
mandate. If licensed, license must be active and unrestricted in state of
practice.
• Valid and unrestricted driver's license, reliable transportation, and adequate
auto insurance for job related travel requirements, unless otherwise required by
law.
• Experience with working with persons with severe and persistent mental health
concerns and serious emotional disturbances, to include substance use disorder
and foster care.
• Knowledge and experience related to whole person care principles, chronic
health conditions, and discharge planning coordination.
• Data entry skills and previous experience utilizing a clinical platform.
• Excellent verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
• Certified Case Manager (CCM).
• Case management experience in a managed care or complex care setting,
particularly with high-risk or vulnerable populations Experience coordinating
rapid transitions of care, supporting safe ED diversion, and reducing avoidable
ED utilization through proactive outreach and care coordination
·Familiarity with integrating medical and behavioral health needs into
individualized care plans, along with an understanding of trauma-informed care,
social determinants of health, and health equity principles
To all current Molina employees: If you are interested in applying for this
position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package.
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V