Behavioral Health Case Manager Resume Samples

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C Rosenbaum

Christian

Rosenbaum

28352 Armstrong Station

New York

+1 (555) 842 9889

28352 Armstrong Station

New York

Phone

p +1 (555) 842 9889

Experience Experience

Houston, TX

Behavioral Health Case Manager

Houston, TX

Stamm, Gutkowski and Stehr

Houston, TX

Behavioral Health Case Manager

Periodically participate and facilitate training programs and/or presentations
Establishes prompt and timely contacts with members, significant others, providers, community agencies and internal health programs
Conducts multiple assessments to establish baseline physical and behavioral health functioning and determine member improvement
Evaluate and assess member in the community setting
Identifies member problems based on analysis of assessments data
Establishes a complete treatment plan to improve and/or maintain member’s level of functioning in the community and tenure in the community setting
Implements intervention strategies aimed towards accomplishing member goals

New York, NY

Lcsw Behavioral Health Case Manager

New York, NY

Blanda Group

New York, NY

Lcsw Behavioral Health Case Manager

Provide support and oversight to other team members managing low risk members
Understand and follow policies and procedures and submit reports in a timely manner
Conduct mental health assessment interviews with members or authorized representatives to obtain social history relevant to BH problems and care planning
Creation of a member-centric care plan utilizing information gathered during the health risk assessment process
Coordinate care with other members of the behavioral/medical interdisciplinary teams
Present complex cases during Interdisciplinary Care Team meetings to gain insight from health services leadership, medical directors, pharmacists, co-workers, etc
Clearly document and track efforts and outcomes

present

San Francisco, CA

Behavioral Health Case Manager Remote

San Francisco, CA

Walsh Inc

present

San Francisco, CA

Behavioral Health Case Manager Remote

present

Identifies cases for individual case management by collecting information obtained from the patient, providers and caregivers
Completes a thorough assessment, develops and implements a case/disease management plan including goals based on the assessment
Coordinates and certifies services based upon information received from attending physician and/or other providers using established medical criteria. (Refers all cases which do not meet criteria to the Medical Director.)
Establishes an effective working relationship with the patient/family, provider and payer
Acts as primary liaison with designated customers (employers), clients (patients), and providers for ongoing care management program operations
Takes part in quality improvement strategies by assessing individual and employer satisfaction of programs, identifying real or potential quality issues and working toward overall quality performance
Adheres to the Case Managers’ ethical principles and standards as described in the CMSA’s Standards of Practice

Education Education

Master’s Degree in Social Work

Adelphi University

Master’s Degree in Social Work

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 Case Manager Remote Resume Examples & Samples

Minimum one year experience in a managed care setting desirable
Valid and unrestricted driver’s license
Identifies cases for individual case management by collecting information obtained from the patient, providers and caregivers
Adheres to the Case Managers’ ethical principles and standards as described in the CMSA’s Standards of Practice
Maintains knowledge of cultural differences including socioeconomic factors, cultural traditions and spiritual beliefs, and researches these differences as needed via libraries, Internet and/or professional journals
Knowledge of applicable state and federal regulations and standards
Experience in Managed Care highly preferred Education
Graduate degree in Social Work or a related field or BSN required Licensure/Certifications

Behavioral Health Case Manager Resume Examples & Samples

Uses appropriate screening criteria, knowledge and clinical judgment to assess member needs
Conducts assessments to identify individual needs and develops care plan to address objectives and goals as identified during assessment
Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers
Experience in case management and telephonic coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders preferred. For Government business only, LAPC, LAMFT, LMSW (as allowed by applicable state laws) is also acceptable in addition to other licensure referenced above; and any other state or federal requirements that may apply

Behavioral Health Case Manager Resume Examples & Samples

Current active unrestricted license as an RN, LCSW (as applicable by state law and scope of practice), LMHC, 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. For Government business only, LAPC, LAMFT, LMSW (as allowed by applicable state laws) is also acceptable in addition to other licensure referenced above; and any other state or federal requirements that may apply
Experience in health coaching and motivational interviewing techniques preferred
This position will require day travel throughout the assigned region in West Virginia 2-3 times per month for meetings with providers and coordinating case management activities, as well as travel to Charleston, WV once a week for team meetings

Behavioral Health Case Manager Resume Examples & Samples

Evaluates the medical necessity and appropriateness of care, optimizing patient outcomes
Establishes and promotes a collaborative relationship with physicians, payers, and other members of the health care team. Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements
Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts into daily practice

Behavioral Health Case Manager Resume Examples & Samples

Assesses, plans, implements, coordinates, 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
Acts as a liaison and member advocate between the member/family, physician and facilities/agencies. Provides clinical social work consultation to physicians, professional staff, and other teams members/supervisors to provide optimal quality patient care and effective operations
Coordinates community resources with emphasis on the development of natural support system. Coordinates benefits, regulations, laws and public entitlement programs
May manage members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability. Acts as team SME in order to achieve optimal clinical and resource outcomes
Required An Associate's Degree in nursing or graduation from Diploma Nursing School (if RN)
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
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 Demonstrated problem solving skills
Required Licensed Clinical Marriage & Family Therapist (LCMFT)
Required Certified Social Worker (C-SW)
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 Case Manager Resume Examples & Samples

Required: Associate's Degree in nursing or graduation from Diploma Nursing School (if RN)
Required: 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: 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
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
Demonstrated interpersonal/verbal communication skills Communicates effectively in person and by phone
Demonstrated written communication skills
Intermediate Microsoft Outlook
Proficient in Microsoft Office including Outlook, Word and Excel
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
LI-SD2

Behavioral Health Case Manager Autism Resume Examples & Samples

Operates as a consultant for other departments
Coordination of Care: Facilitates collaboration between Primary Care, Behavioral Health Care Services and Health Care Providers
Consults with families and other care givers
Provides service information, educational materials and resource information
Linkage with External Resources: Provides linkage of member to community services
Provides individual supportive psychotherapy with client and supportive family counseling when necessary
Coordinates, provides and/or facilitates informational classes, education and/or training in areas such as independent living skills, psycho-education
Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of
At least two (2) years experience in mental health setting and experience working in Inpatient and/or Outpatient treatment services
Minimum two (2) years recent experience in case management and working with community resources, specifically related to the assessment, diagnosis and intervention of Autism Spectrum Disorders. At least two (2) years experience in mental health setting and experience working in Inpatient and/or Outpatient treatment services
Behavioral Health Case Manager - Eating Disorders
Preferred Case Manager Experience with Adult and Child Autisim Spectrum

Behavioral Health Case Manager Resume Examples & Samples

Initial Intervention(Following referral from Inpatient and/or Outpatient Psychiatry Services): Engages with high risk, high utilizing patient populations. Acts as a central point of contact for referrals from multiple departments
Provides assessment and evaluation of clinical status, environmental resources, mental and intellectual capabilities and networking skills
Planning of Services is based on assessment of both short and long term needs
Tracks referrals and outcomes for ongoing quality management
Provides referrals to other departments; facilitates this process and may provide follow-up services as appropriate
Provides brokerage and advocacy when necessary
Facilitates scheduling of multi-disciplinary assessment team and may participate in assessment
Establishes linkages and maintains working relationships with outside resources
Direct Patient Intervention: Provides individual and/or group therapy for chronic, high utilizing patient population
Participates in Intensive Outpatient programs as a team member
Provides crisis assessment and intervention
Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanente's policies and procedures
Relevant experience from one of the following areas shown below
Behavioral Health Case Manager - Generic
Minimum two (2) years recent experience in case management and working with community resources
Behavioral Health Case Manager - Autism
Minimum two (2) years recent experience in case management and working with community resources, specifically related to the assessment, diagnosis and treatment of a variety of Eating Disorders. At least two (2) years experience in mental health setting and experience working in Inpatient and/or Outpatient treatment services

Behavioral Health Case Manager Resume Examples & Samples

RN (Registered Nurse)
LMSW (Licensed Master Social Worker)
LSCSW (Licensed Specialist Clinical Social Worker)
LPC (Licensed Professional Counselor)
LCPC (Licensed Clinical Professional Counselor)
LMLP (Licensed Master Level Psychologist)
LCP (Licensed Clinical Psychotherapist)
LMFT (Licensed Marriage Family Therapist)
LCMFT (Licensed Clinical Marriage Family Therapist)

Licensed Behavioral Health Case Manager Resume Examples & Samples

Accept manual referrals from assigned practices for Behavioral Health case management or consultation for members with serious Behavioral Health conditions
Facilitate member access to Behavioral Health providers for continuing treatment and follow up
Participate in practice rounds
Assist with Behavioral Health-related population management
Provide BH support for joint Aetna/practice clinical initiatives
May need to meet face-to-face with assigned PC groups
3-5 years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility

Behavioral Health Case Manager Resume Examples & Samples

The successful hire will be responsible for the review of Long-Term Disability (LTD) and Short-term Disability (STD) claims with complex medical conditions referred for medical assessment; clarification of limitations/ restrictions; and/or case management
Work closely with the STD/LTD Claims Team to identifying appropriate claim referrals and effectively assessing claims to ensure they reach the appropriate claim outcome
Collaborate with Rehabilitation Case Managers; Ability Analysts; Employees, Policyholders, Healthcare Providers, and Vendors to facilitate and coordinate case management strategies to facilitate a potential Return to Work
Clearly document and track efforts and outcomes
Periodically participate and facilitate training programs and/or presentations
At least 3 years of current clinical experience in an acute care, orthopedic, rehabilitation; industrial medical settings; behavioral health settings, or current experience as a disability case manager
Licensed Mental Health Professional highly preferred or Registered Nurse (RN) with aPsychology or Behavioral Health background
CCM, CDMS, COHN, CRRN or comparable industry certification preferred
Clinical ability to assess claims with complex medical histories which may include claimants with subjective diagnoses, co-morbid conditions, etc
Strong written/ verbal communication skills; computers and Microsoft Office programs
Ability to explain complex medical conditions and ability to communicate with attending physicians to identify current limitations/restrictions as it relates to the work place
Accurate clinical assessment and analytical skills, ability to make sound judgments and to accurately document activities, and the desire to learn about the insurance business
Prior experience in facilitating RTW for disabled employees, knowledge of return to work best practices, ergonomics, FMLA, and related Human Resources is desired
Must keep current in area of expertise and acquire CEU's as necessary to maintain certification
Negotiation skills, problem solving, plan development competencies are essential
Organizational and Change Management skills, accountability in meeting deadlines, and being a team player are also essential

Behavioral Health Case Manager Resume Examples & Samples

Completes assessments by gathering information from the member, family, provider, state and local agencies, and other stakeholders according to department's guidelines and timeframes
Coordinates care across the care continuum for members receiving behavioral heath and substance abuse services
Serves as the member's point of contact for accountability
Develops, implements, monitors and evaluates a comprehensive care plan in collaboration with member, family/caregivers, providers, state and local agencies
Works as a liaison to arrange and coordinate services with community partners including the Virginia Department of Health, state and local agencies for care coordination, referrals and treatment arrangements which may occur as a KP covered service, carved out service or under a waiver program
Serves as the primary point of contact for Medicaid Behavioral Health Management. Tracks DMAS reports, coordinates care for carved in/out services
Serves on the state's Behavioral Health Services Administrator QI Committee and participates in clinical management rounds
Participates in meetings with behavioral health providers to inform them of case management services and benefits available to the members
Refer members to the state of Virginia who are transitioning to residential treatment
Maintains a list of providers, agencies and programs that can benefit the member. These include KP, network, carved out/ excluded services and waiver programs
Maintain current and accurate documentation of contacts, treatment plans, case notes, referrals and assessments in the electronic health record (HealthConnect). Tracking elements are entered in the Case Module of HealthConnect
Supports Behavioral Health Quality Assurance Activities including but not limited to meeting HEDIS Targets and reducing Inpatient Readmission rates
Resolves telephone and written inquiries from members and consultants
Maintains and updates knowledge of treatment approaches, philosophies and techniques for Mental Health/Behavioral Health diagnostic categories
Maintains knowledge of current DSM and CPT coding categories
Collaborates with Behavioral Health Referral Assistants and Manager in maintaining and improving the Network referral process
Assists Behavior Health Managers with special projects as assigned
Performs other related job duties as requested by Behavioral Health Department Manager
Five (5) years of recent experience (within the past seven (7) years) in behavioral health care required
Two (2) years of experience (within the past five (5) years) in case management required
One (1) year of experience and the ability to communicate effectively with consultants, members, and Health Plan/MAPMG providers required
Experience in both ambulatory and in-patient setting preferred
Experience working with dual diagnosed patients preferred
Experience and working knowledge of Community Service Boards preferred
Experience with motivational interviewing preferred
Chronic Care Professional Certification through the Health Science Institute preferred. If applicant does not have the certification, completion of Motivational Interviewing Skill Building Webinar Series through the Health Science Institute is required within six (6) months of hire

Behavioral Health Case Manager Resume Examples & Samples

3 years clinical experience in social work, counseling with broad range of experience with complex 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 LPC, LAPC, LMFT, LMSW or LCSW to practice as a health professional within the scope of licensure in the state of Georgia required
Requires strong computer skills including MS Office, especially MS Excel
Experience with Adoption Assistance preferred

Behavioral Health Case Manager Resume Examples & Samples

Current active unrestricted license as an RN, LPC, LAPC, LMFT, LMSW or LCSW to practice as a health professional within the scope of licensure in the state of Georgia required
Experience with Foster Care and Complex Case Management preferred
Requires field work approximately 60-80% of the time

Behavioral Health Case Manager Resume Examples & Samples

Minimum of five (5) years psychiatric and/or substance abuse experience with at least three (3) years of clinical experience required
Experience in behavioral health settings that include inpatient, partial, and/or outpatient care required. Must be knowledgeable about community care resources and levels of mental health care available
2 years experience in Utilization Management, Case Management or Managed Care preferred
Certified Case Manager (CCM) is preferred upon employment, and Case Managers are required to obtain certification within 4 years of being hired as a Case Manager
Excellent oral and written communication skills, with problem-solving abilities
Ability to build rapport and engage members in effective dialogue related to their treatment plan
Exceptional level of critical thinking, analytical and creative problem solving skills required
Excellent assessment skills

Behavioral Health Case Manager Resume Examples & Samples

Licensed in Minnesota as LICSW, LMFT, LPCC, or PhD LP
Minimum of 3 years clinical practice experience; minimum of 3 years relevant utilization review, discharge planning, or case management experience; and current clinical knowledge
Demonstrated effective, clinical judgment and skills
Ability to deal with change and ambiguity

Behavioral Health Case Manager Resume Examples & Samples

Requires MS or MA in social work, counseling, nursing or related behavioral health field. Your experience must include 3 years' clinical experience in social work, counseling with a broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background
Requires Community Mental Health experience; CSB (Community Service Board) experience; experience working with the ID/DD population
Current, unrestricted RN, LCSW, LPC, or LPN license in the state of Virginia
Knowledgeable of involuntary psychiatric admissions related to emergency custody orders and temporary detention orders

LTC Behavioral Health Case Manager Resume Examples & Samples

Assessment of members to identify unmet needs, coordinate services, community resources and treatment needs
Delivering a holistic approach to coordinated care based on the enrollee needs
Creating, reviewing and revising Plan of Care plans and focusing on disease management
Functioning as an advocate for members and decreasing unnecessary hospitalizations
Building relationships with members and their families; assisting them with proper health choices
Ensuring cases are documented in a timely manner
Licensed by the Arizona Board of Behavioral Health Examiners as a LBSW, LMSW, or LCSW OR Licensed in Arizona as a Registered Nurse with at least two years of experience working in a psychiatric setting or behavioral health clinic
Three years of experience working with persons who have a serious mental illness as a case manager, behavioral health technician, supervisor of case managers or a behavioral health professional
Knowledge about how traumatic brain injuries can affect behavior
Knowledge about the behaviors associated with dementia
Bilingual-Spanish
Basic knowledge of health conditions such as heart disease, diabetes and stokes

Behavioral Health Case Manager Resume Examples & Samples

Actively participates in departmental PI, as assigned by Quality Coordinator
Completes high quality work in accordance with outlined standards and procedures within defined time frames
Functions as a liaison with Psychiatrists, Nursing Staff, Unit Therapists, and Managed Care Organizations
Participates in treatment teams with Medical Directors, staff psychiatrists, and other clinicians as appropriate
Discusses issues related to staff, group, clients, and other customers with the Clinical Services Manager or department Director, as appropriate
Reviews concurrently all payer type inpatient medical records against various medical necessity criteria
Assures that documentation, certifications, and demographic data for all assigned cases are accurate
Performs reviews according to time frames indicated by policy and/or the Managed Care Organization
Alerts Director and/or Clinical Services Manager and appropriate clinical staff of potential problems affecting insurance reimbursement
Assures appropriate level of care and length of treatment for all assigned cases
Demonstrates ability to make appropriate referrals to next level of care providers with the clear understanding that continuing care planning begins at the time of admission
Demonstrates working knowledge of area referral resources
Knowledge of CMS requirements and 2 midnight rule and implementation of such
Demonstrates the ability to complete all post discharge follow-up as outlined by HBIPS and/or the Managed Care Organization
Manages cases through to resolution
Demonstrates the ability to complete retroactive appeals to include writing effective appeal letters
Demonstrates ability to integrate age specific factors into the plan of care and involves the patient and family in the care plan process as appropriate to age. (Serve Adolescent, Adult and Geriatric populations.)
Consistently protects patient confidentiality as outlined in state and federal statutes
Willingly performs other related duties as assigned or requested in a flexible and positive manner
Requires two to five years experience working in a behavioral health setting, preferably psychiatric inpatient experience; or five years post graduate supervised broad clinical experience
Familiarity with required DSM -5 diagnoses, inpatient psychiatric treatment protocols, brief therapy, and chemical dependency intervention knowledge and skills
Demonstrates interpersonal skill necessary to advocate for patients in regards to managed care organizations
Conducts utilization review and case managed care cases on assigned psychiatric units

Behavioral Health Case Manager Resume Examples & Samples

Documents all services in a timely, accurate and professional manner according to established standards
Provides community outreach services to clients including home visits so as to render services in natural settings
Provides clients with monitoring and training in the self-administration of medications if required in the treatment setting and authorized by the Medical Director

Lcsw Behavioral Health Case Manager Resume Examples & Samples

Develop and implement alternative treatment plans that address individual mental health needs of the member, their benefit plan, and community resources
Conduct mental health assessment interviews with members or authorized representatives to obtain social history relevant to BH problems and care planning
Creation of a member-centric care plan utilizing information gathered during the health risk assessment process
Coordinate care with other members of the behavioral/medical interdisciplinary teams
Provide support and oversight to other team members managing low risk members
Understand and follow policies and procedures and submit reports in a timely manner
Present complex cases during Interdisciplinary Care Team meetings to gain insight from health services leadership, medical directors, pharmacists, co-workers, etc
Unrestricted Clinical Social Worker license in the state of Florida
One year of experience as a licensed BH professional in a clinical or case management setting
Current knowledge of federal and state BH practice guidelines, as well asevidence-based BH treatment guidelines for adult/geriatric population
Fluent in spoken and written Spanish

Behavioral Health Case Manager Altcs Resume Examples & Samples

Ensures qualified behavioral health professionals provide clinically competent consultations and collaborative processes to ALTCS case managers to develop care plans and preserve placements. Provides consultation/collaboration to ALTCS unlicensed case managers with behavioral health experience as needed. Ensures the review of members receiving psychotropic medications. Assists ALTCS case managers with identifying and monitoring members who require petitioning, are on court ordered treatment and ensure the timeliness of judicial reviews. Provides and/or facilitates case management and/or social work, and/or other related activities and serves as a resource to other staff members. Promotes interdisciplinary patient care planning and supports Care Model
Participates in the development of the department budget in conjunction with established goals and objectives. Plays a key role in ensuring budgetary goals are met on an annual basis
Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies

Behavioral Health Case Manager Resume Examples & Samples

Working with members identified as high risk to improve quality of life for both behavioral and physical health issues
Develop and monitor the Case Management Care Plan
Work telephonically and in the field with the patients identified as high risk
Experience in psychiatric and medical health care settings

LTC Behavioral Health Case Manager Resume Examples & Samples

Licensed Behavioral Health Professional OR Licensed in Arizona as a Registered Nurse with at least two years of experience working in a psychiatric setting or behavioral health clinic
Licensed by the Arizona Board of Behavioral Health Examiners as a LBSW, LMSW, or LCSW
Bilingual - Spanish

Behavioral Health Case Manager Resume Examples & Samples

Requires MS or MA in social work, counseling, or a related behavioral health field
Current active unrestricted license as an, LCSW (as applicable by state law and scope of practice), LMHC, LPC (as allowed by applicable state laws), or LMFT to practice as a health professional within the scope of licensure in applicable states or territory of the United States required
For Government business only, LAPC, LAMFT, LMSW (as allowed by applicable state laws) is also acceptable in addition to other licensure referenced above; and any other state or federal requirements that may apply
SED waiver or Community Mental Health Center experience preferred

Behavioral Health Case Manager Resume Examples & Samples

Responds to more complex cases and account specific requests
Conducts assessments to identify individual needs and develops specific care plan to address objectives and goals as identified during assessment
May serve as a resource to other BH Case Mgrs

Behavioral Health Case Manager Resume Examples & Samples

Utilize best practice standards to render medical necessity determinations
Adhere to departmental and state guidelines, and clinical standards of care through collaboration with providers to ensure appropriate outcomes
Communicate with patients, family and other medical personnel as necessary to facilitate a desired outcome
Collaborate with Physician Advisor; assess appropriateness and effectiveness of medications to determine a medications use, dosage, side effect as applied to different disease states
Manage electronic files to create patient files to document patient records, treatments, and progress
1-3 years Clinical and Managed Healthcare experience required
3-5 years experience required
NYS LMSW, LCSW, LMHC, or, CASAC and RN

Behavioral Health Case Manager Resume Examples & Samples

Follow up is provided to members identified as needing coordination of care for behavioral and/or medical concerns
Members have single point of contact for continuity of care
High risk members are identified for coordination of services within the various service delivery systems
Provide and improve quality care to members to achieve optimal health outcomes
Members are aware of available services for which they are eligible
Members receive services to meet their identified needs
Clinical care is coordinated among the interdisciplinary service providers involved in the member’s care
Health Choice staff serve as single point of contact
Upon discharge, member transitions to safe, appropriate environment with effective continuity of care
Interdisciplinary team is engaged with the member to create care plan and discharge plan

Behavioral Health Case Manager Resume Examples & Samples

Provides comprehensive (psychosocial) assessment services for patients from the time of admission to facilitate discharge planning. Conducts assessments of patient and family to obtain history and identify precipitants for hospitalization. Assesses patients' emotional status, psychosocial stability, adjustment to acute illness or chronic disability, as well as family support system and financial conditions
Contacts current or previous behavioral health providers, employers and employee assistance programs (EAP’s), designated school personnel and additional collateral/supportive contacts to obtain relevant clinical data needed for coordination of care and discharge planning and for inclusion in this process
Facilitates post-acute care and discharge planning for assigned patients. Conducts criteria identified assessment and coordination for referrals to psychiatric home health, skilled nursing, intermediate care, assisted living and other supportive living facilities. Facilitates transition of patient to rehabilitation and residential placement as well as transfers to other acute levels of care. Continuously communicates provisional discharge plan to patients and families throughout the hospitalization in order to help patient with adjustment to hospitalization and to facilitate discharge plan including coordination of care post hospital care, documenting necessary information in the patient’s after visit summary, as well as coordinating and documenting increased and decreased level of care changes
Completes, compiles and coordinates legal documents required by the Illinois Mental Health and Developmental Disabilities Code (MHDDC) involving involuntary admissions of patients on an inpatient basis. Prepares records for mental health court proceedings and participates in this process as directed by the Office of the Cook County State’s Attorney. Provides notice of patient’s discharge to petitioner when indicated. Reports other patient issues to state and community agencies as required by hospital policy or state/federal law
Provides assistance to patients and families regarding the initiation of the legal process of appointment of guardians and for the supervision of disabled persons once patient is returned to the community
Provides educational and psychological therapies to assist patients and their families in coping with problems related to their illness and/or disability with focus on personal adjustment, family dynamics, community relationships and other social adjustment, e.g. vocational/occupational roles. This is facilitated through the use of appropriate individual, family and group professional treatment modalities
Develops an individualized comprehensive treatment plan in conjunction with attending physician and interdisciplinary hospital team, patient and family. Coordinates the regular review of treatment plan for use in clinical team meetings, staffing, providing case management input based on patient, family and other collateral contact. Updates treatment plan during the patient’s course of treatment and participates as necessary in patient care conferences to discuss discharge planning factors
Maintains accurate and timely medical records (clinical documentation) including psycho-social assessments, family sessions and daily progress notes to include school personnel and other community collateral involvement. Provides descriptions of therapeutic interventions and patient response for discharge planning process
Maintains a comprehensive knowledge of community resources as well as professional relationships with allied health and community referral sources to assure appropriate linkage at discharge
Responds to psychiatric emergency codes utilizing training in management of aggressive behavior
Maintains knowledge of current trends and developments in the field by reading appropriate books, journals and other literature and by attending related conferences and other trainings. As needed, serves as spokesperson before professional or community groups
Master’s degree from an accredited school of Social Work required
Current LSW (Licensed Social Worker), LPC (Licensed Professional Counselor) or Clinical Psychologist to practice in the State of Illinois required. LCSW (Licensed Clinical Social Worker), LCPC (Licensed Clinical Professional Counselor) preferred
Minimum of 2 years experience in a behavioral health environment
Completion of training and certification in CPI
Working knowledge of developmental psychology, disease pathology and clinical needs of assigned population
Ability to maintain highly confidential information
Ability to concisely summarize pertinent clinical information via written correspondence and electronic medical records documentation
Ability to demonstrate professional demeanor in volatile or hostile situations
Ability to set therapeutic limits and maintain professional therapeutic boundaries with patients and families during treatment and post discharge
The analytical skills necessary to conduct through patient care coordination in highly complex cases and to assist in the clinical component of the interdisciplinary treatment plan
The organizational skills necessary to prioritize multiple assignments given simultaneously
The written communication skills necessary to document patient clinical information being mindful of continued review criteria
Thorough knowledge of the Illinois Mental Health and Developmental Disabilities Code

Behavioral Health Case Manager Resume Examples & Samples

Utilize knowledge of mental health system and engagement skills to link members being discharged from inpatient facilities to ongoing outpatient care. Adhere to clinical standards of care through collaboration with providers in order to ensure appropriate outcomes
Practice and adhere to departmental and state guidelines in order to protect self, members and the organization
3+ years experience working with Behavioral Health and/or Substance Use required
LMSW, LCSW, LMHC, RN, or Licensed Psychologist (Ph.D. or Psy.D.); CASAC a plus when in conjunction with required licensure

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