Behavioral Health Care Manager Resume Samples

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A Bosco

Anais

Bosco

723 Malachi Squares

San Francisco

+1 (555) 325 5359

723 Malachi Squares

San Francisco

Phone

p +1 (555) 325 5359

Experience Experience

Philadelphia, PA

Behavioral Health Care Manager

Philadelphia, PA

Gerhold, Skiles and Carroll

Philadelphia, PA

Behavioral Health Care Manager

Collaborates with the PCP and follows through with the identified plan in a timely manner
Communicates with the PCP and team at specific identified times the status of patients at high risk
Provides consultation to CM colleagues for patients with BH issues
Competency in this position is dependent upon the patient population as the position does provide patient care/services
Knowledge of disease processes and/or diagnosis
Familiarity with guardianship issues
Embraces technological advances that allow SHCN to communicate information effectively and efficiently

New York, NY

Behavioral Health Care Manager / Consultant

New York, NY

Muller LLC

New York, NY

Behavioral Health Care Manager / Consultant

Facilitates implementation of the behavioral health collaborative care model in primary care or subspecialty medical/surgical practice setting
Collaborates with clinical and non-clinical practice staff on the performance of behavioral health screening and related processes
Performs psychosocial care management in primary care or subspecialty medical/surgical practice setting
Serves as a liaison with behavioral health service line to facilitate practice adoption of new technologies, including telepsychiatry capabilities
Coordinates necessary resources to move patient along continuum in a timely manner
Serves as a resource to physician and staff by providing guidance and solutions in behavioral health-related processes (screening, treatment algorithms, psychopharmacology principles, escalation, psychiatric consults, etc.)
Monitors, documents, and follows up on practice behavioral health activities to ensure integration and compliance. Prepares and presents reports to service line leadership

present

Houston, TX

Behavioral Health Care Manager Tx-irving After Hours Lcsw

Houston, TX

Lang and Sons

present

Houston, TX

Behavioral Health Care Manager Tx-irving After Hours Lcsw

present

Performs other duties as assigned
Clearly and completely documents all initial and concurrent reviews, including, but not limited to diagnosis, symptoms, interventions, goals and plan for next review
Closes all cases according to the defined case closure procedure in a timely manner, and in accordance with guidelines established by the department Director
Participates in training of other Care Managers as necessary
Completes EAP authorizations as assigned
Attends weekly Administrative and Peer Review Committee meetings
Authorizes inpatient and/or outpatient treatment according to company's stated criteria

Education Education

Master’s Degree in Behavioral Health

The University of Texas at Austin

Master’s Degree in Behavioral Health

Skills Skills

Intermediate ability to work independently Ability to work independently, handle multiple assignments and prioritize workload
Intermediate ability to multi-task
Intermediate demonstrated time management and priority setting skills
Intermediate demonstrated interpersonal/verbal communication skills; communicates effectively in person and by phone
Advanced ability to create, review and interpret treatment plans Ability to create, review and interpret treatment plans
Intermediate ability to effectively present information and respond to questions from families, members, and providers
Intermediate knowledge of healthcare delivery
Intermediate knowledge of community, state and federal laws and resources
Intermediate demonstrated written communication skills
Intermediate demonstrated customer service skills

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Behavioral Health Care Manager Resume Examples & Samples

Conducts comprehensive assessments of referred member's needs and benefit plan eligibility, and develops a care management treatment plan for members with high level acuity needs
Interacts continuously with members, family, physician(s), and other resources to determine appropriate behavioral action needed to address/support medical needs. Reviews benefits options, researches community resources, coordinates services, trains/creates behavioral routines and enables members to be active participants in their own healthcare
Provides telephone follow-up to ensure members have seen their PCP and are completing their care management treatment plan or preventive care services as defined by the PCP or guidelines
Assists in obtaining benefits for members through community resources when benefits are exhausted or not available
Required an Associate's Degree in nursing or graduation from Diploma Nursing School (if RN)
Required a Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position
Required 1+ year of experience in current case management as a licensed professional
Required experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
Preferred experience in a managed care environment
Intermediate ability to work independently Ability to work independently, handle multiple assignments and prioritize workload
Intermediate demonstrated time management and priority setting skills
Intermediate demonstrated interpersonal/verbal communication skills; communicates effectively in person and by phone
Advanced ability to create, review and interpret treatment plans Ability to create, review and interpret treatment plans
Intermediate knowledge of healthcare delivery
Intermediate demonstrated customer service skills
Required Licensed Clinical Social Worker (LCSW) LSW, LCSW, LMHC, LPC, LMFT, PsyD
Required Licensed Master Social Work (LMSW)
Required Acute Care Nurse Practitioner (APRN) (ACNP-BC)
Required intermediate Microsoft Outlook Proficient in Microsoft Office including Outlook, Word and Excel
Required intermediate Microsoft Word Knowledge of or the ability to learn company approved software such as EMMA, CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties
Required intermediate Other Knowledge of or the ability to learn company approved software such as EMMA, CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties

Behavioral Health Care Manager Tx-irving After Hours Lcsw Resume Examples & Samples

Assesses patient's clinical presentation for medical necessity and appropriateness of proposed evaluation/treatment goals
Authorizes inpatient and/or outpatient treatment according to company's stated criteria
Clearly and completely documents all initial and concurrent reviews, including, but not limited to diagnosis, symptoms, interventions, goals and plan for next review
Consults with Providers as needed, responds to provider questions with regard to EAP or Managed Care cases
Performs provider recruiting duties as needed

Behavioral Health Care Manager Tx-irving Day Shift Lcsw Resume Examples & Samples

Closes all cases according to the defined case closure procedure in a timely manner, and in accordance with guidelines established by the department Director
Participates in training of other Care Managers as necessary
Completes EAP authorizations as assigned
Attends weekly Administrative and Peer Review Committee meetings
Performs special audits, projects, etc. as required

Behavioral Health Care Manager Resume Examples & Samples

Prepares for patient interaction by gathering information from reviewing the patient's medical record when available as well as communicating with the primary care physician (PCP) and other clinical team members
Identifies all situations involving the patient's needs and works independently with the patient/guardian to rectify and manage those needs. Develops trusting, professional, caring relationships with patients and families, engaging respectfully and with utmost attention to service
Communicates effectively with the patient and/or patient representative (guardian) the patient's needs and resources available to meet those needs
Assesses crisis intervention needs and acts appropriately to meet those needs
Collaborates with the PCP and follows through with the identified plan in a timely manner
Communicates with the PCP and team at specific identified times the status of patients at high risk
Provides consultation to CM colleagues for patients with BH issues
Maintains the current documentation requirements
Develops an individualized holistic plan of care for the patient in collaboration with the patient/family/caregiver; performs a psychosocial assessment to determine Behavioral Health Care Management needs and follow-up
For each visit/telephonic interaction, demonstrates the skills and judgment necessary to implement the plan of care as well as any interventions or procedures necessary. This is evident by chart review, observation, and patient interaction
Experience in a health care setting required
Knowledge of and experience with a pediatric/adolescent population
Competency in this position is dependent upon the patient population as the position does provide patient care/services
Knowledge of disease processes and/or diagnosis
Familiarity with guardianship issues
Participates in continued learning and possess a willingness and ability to learn and utilize new technology and procedures that will continue to develop in their role and throughout the organization
Embraces technological advances that allow SHCN to communicate information effectively and efficiently

Behavioral Health Care Manager Resume Examples & Samples

1+ year of prior experience working with Behavioral Health patients
Active NYS Registered Nurse (RN) license
Previous experience working within an Acute Care and/or Inpatient setting
Care / Case Management background
Previous experience with Utilization Review or Discharge Planning

Behavioral Health Care Manager, RN Resume Examples & Samples

Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability
Works towards achievement of optimal clinical and resource outcomes
Monitors and evaluates effectiveness of care plan and modifies plan as needed
Supports member access to appropriate quality and cost effective care
Acts as a liaison and member advocate between the member/family, physician and facilities/agencies
Provides clinical consultation to physicians, professional staff and other teams members/supervisors to provide optimal quality patient care and effective operations
Interacts continuously with members, family, physician(s), and other resources to determine appropriate behavioral action needed to address medical needs
Ensures members are engaging with their PCP to complete their care management treatment plan or preventive care services
Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position or Registered Nurse with behavioral health background is required
Master's level independent or non-independent license OR an RN with a behavioral health background is required
Licensed Clinical Marriage & Family Therapist (LCMFT) is required
Licensed Clinical Psychologist (LCP) is required
Proficient in Microsoft Office including MS Outlook, MS Word and MS Excel is required
Healthcare Management Systems (Generic) is required *LI-RG1

Behavioral Health Care Manager Resume Examples & Samples

Assesses, plans, implements, monitors and evaluates options and services to meet complex psychosocial health needs of inpatient and outpatient members. Manages a caseload in compliance with contractual obligations and WellCare standards
Conducts comprehensive member assessments through root cause analysis based on referred member's needs and benefit plan eligibility, and performs clinical intervention through the development of a care management treatment plan specific to each member with high level acuity needs
Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability. Works towards achievement of optimal clinical and resource outcomes
Acts as a liaison and member advocate between the member/family, physician and facilities/agencies. Provides clinical consultation to physicians, professional staff and other teams members/supervisors to provide optimal quality patient care and effective operations
Interacts continuously with members, family, physician(s), and other resources to determine appropriate behavioral action needed to address medical needs. Reviews benefits options, researches community resources, trains/creates behavioral routines and enables members to be active participants in their own healthcare
Required A Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position
Preferred Other Experience in a managed care environment
Required Other A master's level independent or non-independent license is required OR an RN with a behavioral health background
Required Other NJ Only - post graduate (master level) LSW
Required Intermediate Microsoft Outlook Proficient in Microsoft Office including Outlook, Word and Excel

Behavioral Health Care Manager Resume Examples & Samples

Required A Master's Degree in Social Work, or Counseling, or other relevant field that provides a foundation to receive a license as required of the position
Required Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
Preferred Experience in a managed care environment
Required - A Master's level independent or non-independent license is required
In New Jersey, one of the following is Required: Licensed Social Worker (LSW), Licensed Associate Counselor (LAC) or Registered Nurse (RN) with a behavioral health background
Preferred - Licensed Clinical Social Worker (LCSW) or Licensed Professional Counselor (LPC)

Behavioral Health Care Manager Resume Examples & Samples

Contribute to a team oriented environment based on exhibiting the characteristic of positive expectancy
Work collaboratively with other members of the Humana Interdisciplinary team, including medical counterparts performing medical case management
Comply with performance and reporting standards as defined by Humana
Contribute to an increases in scores on Kenexa Engagement surveys and Well-being Index by being actively involved in Impact Planning, and promoting associate engagement and participation, in well-being opportunities
Contribute to a production-oriented call center environment with variety of tasks
Meet key performance standards including audits, weekly successful closure expectations, and caseload maintenance
Understand case management concepts and how these concepts are applied to a member population within a telephonic environment
Use your interpersonal skills including proficiency in Motivational Interviewing and Solution Focused Therapy
Exercise sound clinical judgment and engage in ethical behavior, including practicing of case management within scope of licensure
Understanding members in their current life situation, and develop and implement personalized S.M.A.R.T. goals and treatment plans
Conceptualize and present clinical cases in concise and clear manner
Provide training and feedback to medical case managers as needed
Additional responsibilities as deemed appropriate by Humana leadership
Must be available to work 10 – 7 p.m. if located in the CST time zone
Master’s degree in healthcare-related field or current licensure as a Registered Nurse
Current valid license in state of residence as a Social Worker (LMSW), Professional Counselor (LPC or state equivalent), marriage and family therapist (LMFT), or Registered Nurse (RN)
Comfortable working in fast-paced, production-oriented, call center environment handling a variety of tasks
Ability to meet key performance standards including audits, successful closures, and caseload maintenance
Skilled in balancing and executing on multiple tasks, including caseload management
Technical competence with Microsoft Office Programs, e.g. Word, Excel, PowerPoint, and excellent keyboard and web navigation skills
Exceptional communication and interpersonal skills including Motivational Interviewing and Solution Focused tools
Ability to exercise sound clinical judgment and engage in ethical behavior, including practicing of case management within scope of licensure
Ability to meet members in their current life situation, and develop and implement personalized S.M.A.R.T. goals and treatment plans
Valid Certified Case Manager (CCM) certification

Behavioral Health Care Manager Resume Examples & Samples

Assesses, plans, implements, monitors and evaluates options and services to meet complex psychosocial health needs of inpatient and outpatient members
Manages a caseload in compliance with contractual obligations and WellCare standards
Monitors and evaluates effectiveness of care plan and modifies plan as needed. Supports member access to appropriate quality and cost effective care
Coordinates with internal and external resources to meet identified needs of the member's care plan and collaborates with providers
Reviews benefits options, researches community resources, trains/creates behavioral routines and enables members to be active participants in their own healthcare
Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position is required
2+ years of experience in behavioral health management and/or acute behavioral health care setting focusing on outpatient/inpatient utilization, case management and discharge planning is required
1+ year of experience in current case management as a licensed professional is required
Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs is required
Experience in a managed care environment is preferred
Ability to work independently, handle multiple assignments and prioritize workload
Demonstrated customer service skills
Master's level independent or non-independent license is required OR an RN with a behavioral health background is required
Licensed Clinical Social Worker (LCSW) LSW, LCSW, LMHC, LPC, LMFT, PsyD is required
Licensed Clinical Mental Health Counselor (LCMHC) is required
Licensed Clinical Professional Counselor (LCPC) is required
Licensed Master Social Work (LMSW) is required
Certified Social Worker (C-SW) is required
Acute Care Nurse Practitioner (APRN) (ACNP-BC) is required
Knowledge of or the ability to learn company approved software such as EMMA, CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties is required

Behavioral Health Care Manager Lead-indiana Resume Examples & Samples

Requires MS or MA in social work, counseling, nursing or related behavioral health field; 5+ years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background
Current active unrestricted license as an RN, LCSW, LMSW, LMHC, LPC, LBA (as allowed by applicable state laws), LMFT, or clinical Psychologist, to practice as a health professional within the scope of licensure in applicable states or territory of the United States required
Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required
Prior managed care experience required

Behavioral Health Care Manager Resume Examples & Samples

Conducts all necessary direct utilization management activities for behavioral health plan members including service coordination for members in crisis, crisis intervention, behavioral health triage, crisis assessment services, pre-certification and authorization of care for both psychiatric and chemical dependency services, all necessary concurrent review with hospitals and mental health centers, discharge and aftercare planning and referrals for continued outpatient care
Interacts on a daily basis with hospital representatives and attending psychiatrists and coordinates physician-to-physician reviews with the medical director. Reviews treatment plans and consults with medical director regarding medical necessity criteria for continued inpatient stay. Facilitates community placements, agency linkages and coordinates discharge planning, aftercare, referral and follow-up of inpatients
Identifies high risk/high volume members for more intensive follow-up care and conducts hand-off coordination between Clinical Coordinators and providers
Ensures members have access, availability and quality care according to standards
Performs all other clinical and administrative duties as assigned
1+ year clinical behavioral health experience providing direct patient care services

Behavioral Health Care Manager Resume Examples & Samples

Requires MS or MA in social work, counseling, nursing or a related behavioral health field
3-4 years experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background
Current active unrestricted license as an RN, LCSW, LMSW, LMHC, LPC, LBA (as allowed by applicable state laws), LMFT, or Clinical Psychologist, to practice as a health professional within the scope of licensure in applicable states or territory of the United States required

Behavioral Health Care Manager / Consultant Resume Examples & Samples

Facilitates implementation of the behavioral health collaborative care model in primary care or subspecialty medical/surgical practice setting
Collaborates with clinical and non-clinical practice staff on the performance of behavioral health screening and related processes
Serves as a resource to physician and staff by providing guidance and solutions in behavioral health-related processes (screening, treatment algorithms, psychopharmacology principles, escalation, psychiatric consults, etc.)
Serves as a liaison with behavioral health service line to facilitate practice adoption of new technologies, including telepsychiatry capabilities
Monitors, documents, and follows up on practice behavioral health activities to ensure integration and compliance. Prepares and presents reports to service line leadership
Performs psychosocial care management in primary care or subspecialty medical/surgical practice setting
Obtains and utilizes patient information to develop a psychosocial care plan to address identified patient needs, as required
Coordinates necessary resources to move patient along continuum in a timely manner
Monitors patient’s progress and intervenes, as necessary, to ensure care provided are patient focused, high quality, efficient, and cost effective
Contributes to healthcare team’s, patient’s and family’s understanding of social and emotional elements of patient’s life related to diagnoses and treatments
Collaborates with RNs and RN Care Managers to identify and manage treatment of complicated and high risk cases to foster positive outcomes
Provides brief psychotherapeutic services to patients, in accordance with behavioral collaborative care model, as needed
Completes documentation in accordance with policies and procedures of the organization, state and federal regulations
New York State licensure in one (1) of the following professions, required
Licensed Master Social Worker (LMSW)
Licensed Mental Health Counselor (LMHC)
Licensed Psychologist

Behavioral Health Care Manager Resume Examples & Samples

Required A Master's Degree in clinical social work, psychology, counseling, rehabilitation etc. (if LSCW)
Required 1+ year of experience in clinical behavioral health experience providing direct patient care services
Preferred Other Experience providing care management or utilization management services in a managed behavioral health organization, community mental health center, health plan or hospital
Required Intermediate Microsoft Outlook Ability to communicate on any level required to meet the demands of the position

Behavioral Health Care Manager Resume Examples & Samples

Intermediate demonstrated interpersonal/verbal communication skills Communicates effectively in person and by phone
Required intermediate Microsoft Office including Outlook, Word and Excel
Required Intermediate ability to learn company approved software such as EMMA, CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties

Behavioral Health Care Manager Lcsw Resume Examples & Samples

Screen: Identifies patients and their needs utilizing specific screening criteria. Maintains an effective Care Management program through early identification of members requiring Care Management
Assess: Gathers all relevant data and obtains information by interviewing the patient/family/significant other and performs an evaluation. Evaluates all relevant information to identify barriers, determines realistic goals and objectives and seeks potential alternatives. Authorizes appropriate behavioral health services. Completes and follows up on any notifications as directed by Intake Coordinators. Calls the initiating individual with approval or denial status
Plan: Works with the member, family/significant other, physician and other health care providers to develop a plan or plans of care that optimizes member outcomes. Initiates and implements plan modifications as necessary through monitoring and re-evaluation to accommodate changes in treatment or progress. Evaluates quality and appropriateness of inpatient and outpatient care. Directs members to appropriate facilities. Performs cost-benefit analysis and negotiates rates with providers and vendors. Assures that benefits, funding and/or community resources are available to implement the plan and coordinates appropriate use of resources and level of services. Notifies appropriate management of any large claim, high-risk members who are requiring, or will require, intensive and/or costly services
Facilitate: Actively communicates and collaborates between all team members, member/family/significant other and providers to enhance and maximize outcomes. Minimizes or eliminates unnecessary steps, promotes timely provision of care and promotes efficient use of resources. Compares the member's course to an established clinical pathway to determine variances
Advocate: Ensures the member?s individualized needs and goals are incorporated throughout the care management process. Supports and educates the member to become empowered, self-reliant and a self advocate. Represents the member?s best interest through advocacy for necessary funding, treatment alternatives, timeliness, coordination of health services and frequent re-evaluation of progress and goals
Triage/Referral and Utilization Management: Maintains consistent availability to triage and referral staff. Makes referral and triage decisions that require clinical staff management. Assists to ensure staff are consistent with application of approved criteria. Assists to ensure that UM decisions are made in a timely manner and pursuant to policy
Other Job Related Responsibilities: Maintains a knowledge base of current medical and mental health policies, procedures and services, SelectHealth's plan designs and paneled providers and all applicable NCQA guidelines. Assists with implementing department improvement plans as they relate to member satisfaction regulatory body requirements and financial performance. Participates in staff training. Participates in monitoring of documentation adequacy. May participate on committees to improve care process models, evaluate opportunities for appropriate cost containment and improve member satisfaction

Behavioral Health Care Manager Resume Examples & Samples

MS or MA in social work, counseling, nursing or a related behavioral health field
3 years’ experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background
Current active unrestricted license as a RN (Psychiatric), LCSW, LMSW, LPC, LMFT, LMHC, or Clinical Psychologist to practice as a health professional within the scope of licensure in the state of New York
Experience working with electronic databases, multiple PC’s, and data entry
Experience with ABA Services a plus

Behavioral Health Care Manager Resume Examples & Samples

Graduate degree from an accredited educational program in Social Work, Clinical/Counseling Psychology, or Nursing. Direct practice in a Children’s Behavioral Health Level of Care ( ie. BHRS, FBMHS, RTF, etc)
Minimum three years post graduate clinical experience or equivalent combination of education and clinically related work experience. Minimum one year experience working with a managed care system. Minimum one year experience in Behavioral Health Service Delivery System. Knowledge base in Medicaid, Medicare and Commercial Managed Care Systems
Ability to provide constructive feedback with a focus on improved quality

Behavioral Health Care Manager Resume Examples & Samples

Minimum two years of experience in behavioral health setting
Must be able to prioritize work and develop strategies for adapting to constantly changing priorities and urgencies
Demonstrate cultural competency and sensitivity
Experience with Motivational Interviewing and/or Health Coaching a plus
Comfort with End of Life and Goals of Care discussions
Experience or background in Behavioral Health a plus

Behavioral Health Care Manager Resume Examples & Samples

Current unrestricted license as an LCSW, LMHC, LPC (LPC as allowed by applicable state laws), Marriage and Family Therapist, or clinical Psychologist required
Requires a MS in social work, counseling or a related behavioral health field
Requires at least 3 years of experience with facility-based and/or outpatient psychiatric and chemical dependency treatment; or any combination of education and experience, which would provide an equivalent background
Previous experiences in case management/utilization review preferred

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