Job Description

Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nations leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to hear you. Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at **Responsibilities:** The Behavioral Health Clinical Care Manager (CCM) is a core participant of the collaborative care team, including the member/family, behavioral health providers, behavioral health service system, Physical Health (PH)-Managed Care Organization (MCO) and medical providers when applicable, as well as the larger primary care team. The CCM is responsible for proving utilization management and both case and care management, as well as supporting and coordinating the behavioral health care of members per assigned caseload, with the members/guardian, school system, behavioral health care provider and, when appropriate, other medical providers. Coordination of care including PH-BH, referrals, follow up, authorization determinations, connection to natural/community supports including SDoH supports, and quality of care are key components of the BH CCM role. **Education:** + Associate degree in Nursing required; Bachelor of Science in Nursing preferred + Master degree in Social work required **Licensure:** + Current and unrestricted RN Michigan licensure required + Current and unrestricted LCSW, LMSW Michigan licensure required **Location:** + **Qualified candidates must be resident of Michigan per contractual requirements** **Experience:** + Minimum 3 years post graduate clinical experience or equivalent combination of education and clinically related work experience.(RN requires 2 years of psychiatric adult or children's direct practice experience). + 1+ year of experience in Children's Behavioral Health Service Delivery System preferred. + Direct clinical practice experience with adults and pediatrics providing behavioral health level of care (i.e. MH IP, PHP, MH OP, SUD) + Knowledge base in Medicaid, Medicare or Commercial Managed Care Systems. + Knowledge base and experience with differential diagnosis screening, assessment and treatment planning for common mental health & substance use disorders. + Demonstrated knowledge of plan benefit information and managed care. + PC Skills and Experience utilizing Microsoft Office, Outlook, Excel, PowerPoint and typing skills. + Ability to provide constructive feedback with a focus on improved quality of care. + Ability to communicate in a positive/professional manner both verbally and written. + Ability to work independently, complete multiple tasks in the allotted timeframe. + Strong problem-solving skills and decision making skills. + Demonstrated ability to collaborate and communicate effectively in a team setting. + Ability to maintain effective and professional relationships with member/guardian and others on care team. + Knowledge base and experience with differential diagnosis screening, assessment and treatment planning for common mental health & substance use disorders. + Ability to effectively engage member/guardian in a therapeutic relationship, when appropriate. + Ability to work with member/guardian and providers telephonically. + Knowledge base in evidence-based treatments and brief behavioral interventions for common mental health disorders (e.g., motivational interviewing, problem-solving treatment, behavioral activation other evidence-based programs). + Knowledge of psychopharmacology for common mental health disorders that is within appropriate scope of practice for CCM role. + Ability to work effectively in a team environment. + Current driver's license and valid car insurance. + Must be willing to meet with members F2F if needed at a community center, facility, or provider's office. **Our Comprehensive Benefits Package** Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more. \#PH As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

Job Tags

Work experience placement, Work at office, Remote work, Flexible hours,

Similar Jobs