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Behavioral Case Mgr

Company: Centene Coproration
Location: San Rafael
Posted on: August 24, 2019

Job Description:

Description: Position Purpose: Perform duties related to the day to day operations of the Integrated Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life for both behavioral and physical health issues. Assess members' current functional level and, in collaboration with the member, develop and monitor the Case Management Care Plan, monitor quality of care; assisting with discharge planning, participating in special clinical projects and communicate with departmental and plan administrative staff to facilitate daily operations of the Integrated Case Management functions. Collaborate with both medical and behavioral providers to ensure optimal care for members. Work telephonically with patients identified as high risk, for both behavioral and physical health issues, and their providers to identify needs, set goals and implement action steps towards achieving goals. Empower patients to help them improve their quality of life and ensure an integrated approach to address complex issues. Understand and comply with NCQA guidelines and HEDIS measures. Comply with established referral, pre-certification and authorization policies, procedures and processes by related Medical Management staff.

Keywords: Centene Coproration, Laguna , Behavioral Case Mgr, Other , San Rafael, California

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