Perform duties related to the day-to-day operations of the Behavioral Health Team. Case Management works with high risk Members to help identify needs and goals to achieve empowerment and improved quality of life for both behavioral and physical health issues. Assessed Members current functional level and, in collaboration with the Member, develops and monitors the Case Management Care Plan, 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 Behavioral Health Case Management functions. Collaborate with both medical and behavioral providers, often onsite at hospitals or in the community, to ensure optimal care for Members. Work telephonically with patients and their Legal Authorized Representative 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. Understand and comply with NCQA/ URAC guidelines and HEDIS measures.
Master's Degree in Social Work or Counseling
Current unrestricted license in the state of Texas: LCSW, LMSW, LMFT or LPC
Two years experience in managed care setting and 2 years in behavioral health case management
Advanced PC knowledge, MS Word, MS Excel, MS Outlook, and excellent telephone skills.
Above Average Verbal (Heavy Public Contact)
Writing /Composing (Correspondence / Reports)
Excellent organization, coordination, and multi-tasking skills and abilities. Ability to organize and prioritize tasks and work independently. Strong attention to detail and deadlines.
Will travel locally to hospitals as requested by manager or medical director when high risk or high utilizing member is inpatient.
Internal Number: 148144
About Harris Health System
The Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes 23 community health centers, five school-based clinics, a dental center and dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals.Ben Taub Hospital is a world renowned Level I Trauma Center with 586 licensed acute-care beds and provides a wide range of specialty care outpatient services. Lyndon B. Johnson Hospital is a 328 licensed bed acute-care hospital with a newly expanded Level III trauma center and a distinguished regional center for neonatal intensive care for high-risk deliveries.Harris Health is a teaching system for Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth). We train the next generation of healthcare providers on the latest medical procedures and technological breakthroughs.With... our fully integrated electronic medical records system, we offer patients the convenience and assurance that their medical history is accurate, safe and available when and where it is needed. Our Medical Home designation ensures that we offer a full range of preventive, specialty and acute care services for the entire family.