Clinical Care Manager
Company: Beacon Health Options
Posted on: November 11, 2019
Beacon Health OptionsJob Category: Clinical - Care MgmtReq #:
CAREM01777Schedule: Full TimeLocation: RI - Providence
We Help People Live their Lives to the Fullest Potential!
For more than 30 years, Beacon has changed the way people live with
behavioral health conditions. Today, we are the undisputed leader
in behavioral health management, serving 40 million people across
all 50 states. At Beacon, we are committed to delivering a
'world-class' candidate experience from the moment you click
'Apply'! Our goal is to help you reach your fullest potential,
while utilizing your talents and expertise to help us deliver on
Do you have a passion for helping others? If so, we are looking for
Beacon is currently seeking a Clinical Case Manager to join our
team at our Providence, RI location.The Clinical Case Manager is
responsible for triage and management of members referred to our
case management program. The Clinical Case Manager is also
responsible for the tracking and managing of members identified for
case management who may be high utilizing, at significant risk, or
under-utilizing services. The Clinical Case Manager also maintains
relationships within the provider community to expedite our
member's access to clinically appropriate services, thereby
improving member outcomes. The Clinical Case Manager performs
telephonic outreach to members to assist in identifying needs and
barriers as well as in-person outreach as appropriate and assigned.
Work with members includes, but is not limited to completing a
comprehensive assessment, individualized care plan and work with
the member to aid in the understanding and utilization of services
available to them within the continuum of care. This position will
facilitate tracking all necessary quality indicators to meet
necessary accrediting bodies (i.e. NCQA and URAC)
What does a typical day look like?
- Contribute to a team caseload of 150 members, 20% high
- Maintain an active member caseload of no less than 50 members
at any given point in time
- Completion of a comprehensive assessment within 30 days of
- Appropriate assessment of member acuity for appropriate
- Coordination with team members and supervisor on any issues
with caseload maintenance
- Contribute to the team Engagement rate goal of > =20%
- Upon receipt of referral, attempt to outreach within 1 business
day to member or facility
- Upon notice of discharge, attempt to outreach member within 1
- Maintain active community presence in assigned community
activities, which may include:
- Onsite presence at local hospitals to meet with and engage
- Training of staff and community members on program
- On-site presence at area locations of plan partner to promote
case management program
- Conduct training with local community agencies and hospitals on
- Coordination with plan medical case management and utilization
management staff on referrals and member concerns
- Attend all assigned meetings, trainings and conference calls as
scheduled and on time
- Contribute to no less than bi-weekly individual and bi-weekly
team supervision and meetings
- Perform customer services aspects as required and conduct
business in a professional manner.
- Troubleshoot member issues with provider access, claims, and
other needs as determined. Investigate and research to resolve
customer problems and issues in a timely and satisfactory way.
- Comply with all Beacon policy guidelines, external regulatory
requirements and URAC/NCQA accreditation standards;
- Assists with NCQA, URAC and other QI initiatives;
- Apply Beacon Health Options policies and procedures
- Maintain confidentiality of clients, business records and
- Maintain ethical and professional standards.
- Meet all productivity, performance and departmental standards
- Complete all tasks accurately, appropriately and within
- Other duties as assigned;
What you Contribute?
Education: Master's degree or higher in a health related field and
independent licensure as a behavioral health professional or BSN
Licensure:Current, valid and unrestricted mental/behavioral health
licensure for practice required with proof on date of hire.
Re-verification will take place no less than every 3 years.
Knowledge, Skills & Abilities:
- Must be a licensed behavioral health clinician and practice
within the scope of their licensure with a minimum of 3 years
behavioral health experience. Managed care experience
- Strong verbal and written communication skills.
- Behavioral health experience and understanding of mental health
and substance use services, managed care as well as current
principles, procedures and knowledge domains of case management,
Wraparound and Community-Based Services.
- Good analytic skills and be comfortable working with metrics
- Strong organizational skills
- A high level of ability to work well under pressure and
multi-task between multiple priority items
- Works well in a fast paced environment as well as have
excellent problem solving skills
- Proficiency in Word, Excel needed and PowerPoint
What Makes Us Different?
- Here, it's not just a job - it's an opportunity to change
- Our employees are learners, innovators and original
- Our mission and values guide the way we treat our members,
providers and each other.
What We Have to Offer:
- Healthcare benefits available starting day 1!
- Health & wellbeing incentives, such as gym membership
- 401K with company match to help reach your future financial
- Generous PTO, because we know life happens outside of work
- Tuition reimbursement so you can keep reaching your fullest
If Beacon sounds like the place for you, what are you waiting for?
Apply with us today to get started!
Beacon Health Options is proud to be an Equal Opportunity and
Affirmative Action Employer as well as a Drug Free and Tobacco Free
Work Environment. EOE/AA/M/F/Veterans/Disabled
At Beacon Health Options, our candidate's data privacy is a top
priority. Our recruiting team conducts all communications using
official company email Only candidates who have applied for an open
position through our Careers page (careers.beaconhealthoptions.com)
will be engaged in our interview process. Beacon conducts all
interviews in person or over the phone. At no time during the
recruiting process will any Beacon recruiter request any financial
or personally identifiable information from you.
Keywords: Beacon Health Options, Providence , Clinical Care Manager, Executive , Providence, Rhode Island
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