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Field Based UM Care Manager

Company: Beacon Health Options
Location: Buffalo
Posted on: January 17, 2020

Job Description:

Beacon Health OptionsJob Category: Clinical - Care MgmtReq #: FIELD01999Schedule: Full TimeLocation: NY - BuffaloAbout the Position:

Beacon Health Options is currently seeking a dynamic Field Based UM Care Manager to join our team in Buffalo, NY! The Field Based Care Manager is responsible for outreaching, triaging, assessing, and managing of members from both a utilization & care coordination perspective. The Field Based Care Manager is responsible for the tracking and managing of members who are significant clinical risk and in need of linkage to services and coordination of care.

Position Responsibilities:

  • Telephonic outreach and engagement of Providers and assigned members
  • Conduct in person, face to face outreach visits, at provider facilities and in the community, as needed, to facilitate engagement, assessment and care planning with both members and Providers.
  • Independent and individualized assessment of members enrolled in Care Management.
  • Development of a member centric care plan in collaboration with the member and his/her treatment team
  • Facilitation of interventions and services appropriate to the member's clinical status and available resources.
  • Managing, coordinating care, and identifying strategies to meet care plan goals of assigned members
  • Collaboration and communication with Primary Care Providers and community based providers.
  • Assist in collection of outcomes information, annual analysis and other reporting and initiatives
  • Participation in telephonic and in person case conferences and care planning meetings with members, providers, PCPs and community agencies.
  • Provides care management in compliance with regulatory and accreditation requirements
  • Response to urgent and crisis calls from members
  • Promotes member safety and recovery goals
  • Collaborates and presents cases to Medical Directors
  • Participation in internal Clinical Rounds and Clinical Rounds with Health Plan partners
  • Utilization Review for members
  • Compliance with all turnaround times for both UM and CM
  • Compliance with all documentation and training requirements
  • Other duties as assigned

    Position Requirements:
    • Education: Master's Degree or RN with related psychiatric nursing experience required
    • Licensures: Current, valid, unrestricted independent license in behavioral health or nursing (RN) required
    • Relevant Work Experience: 2 years of direct behavioral health clinical and managed care experience required
    • Knowledge, Skills, & Abilities:
      • Knowledge of current principles, procedures and domains of case management
      • Knowledge of managed care and health plan care management
      • Ability to effectively engaging and communicating with members and providers
      • Ability to meet deadlines and established cycle times through effective prioritization and follow-up skills

        To Apply:

        Click below on "Apply for this Position" to create a profile and apply for the position

        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 (@BeaconHealthOptions.com). 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.



        PM16 PI116729498

Keywords: Beacon Health Options, Buffalo , Field Based UM Care Manager, Executive , Buffalo, New York

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