Outpatient Behavioral Health Care Manager at Capital District Physicians Health Plan Inc in Albany, New York

Job Description:

CDPHP and its family of companies are mission-driven organizations that support the health and well-being of our customers and the communities we are proud to serve. CDPHP was founded in Albany in 1984 as a physician-guided not-for-profit, and currently offers health plans in 29 counties in New York state. The company values integrity, diversity, and innovation, and its corporate culture supports those values wholeheartedly. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.

The Outpatient Behavioral Health Care Manager is responsible and accountable for coordinating the care of CDPHP members with mental health, substance abuse and co-morbid medical disorders across the continuum of care; ensuring and facilitating the achievement of quality, clinical and cost outcomes. Care Managers may work from a variety of locations including, but not limited to, a telephonic managed care setting, a primary care office, at our large volume hospitals or a community room affiliated with a community agency or member home. Many practice settings are in downtown urban areas working with an inner city population. Activities focus on patient education and coordination of care for CDPHP members with a chronic condition. The discrete activities include member outreach, care planning, motivational interviewing and acting as a key clinical liaison between the provider, member and CDPHP. The Care Manager will perform all functions by articulating and documenting in CDPHP applications and, when applicable, a practice's electronic medical record with a high level of accuracy.

They must combine strong clinical knowledge and critical thinking to coordinate and support a care plan that will monitor quality medical and behavioral health care for the member population serviced by CDPHP. Based on national standards for case management practice, the Care Manager will focus on empowering the member to support optimal wellness while advocating for the necessary medical and behavioral health services across the health care continuum.

The Care Manager provides "face to face" and/or telephonic assessments, referrals, and benefit-related counseling to members. Responsible for working strategically and on-site in a consultative role with our large volume hospitals and outpatient providers to develop treatment plans to allow members to function in the least restrictive level of care.

QUALIFICATIONS:

• Advanced degree required. Master's prepared mental health clinician, licensed in NY as LCSW, LMSW, LMHC or CASAC.


• Registered Nurse (RN) with a current New York State license and a minimum of 3 years working in behavioral health may be substituted for degree.


• Minimum two (2) years of case management experience required.


• Minimum one (1) year direct service experience in the delivery of mental health and substance abuse treatment services required.


• Experience with chronic condition management, particularly diabetes and heart disease is preferred.


• Experience with health, social service and funding resources, including community agencies and alternate care delivery systems is required.


• Knowledge of the latest version of the Diagnostic and Statistical Manual of Mental Health Disorders and International Classification of Diseases required.


• Understanding of Microsoft Word, Excel, Outlook and PowerPoint is required.


• Demonstrated ability to develop care plans to ensure behavioral health needs are adequately addressed, including complex behavioral health issues.


• Demonstrated ability to provide case management for complicated members with multiple comorbidities and chronic diseases.


• Demonstrated ability to influence others while motivating them to change.


• Demonstrated ability to communicate effectively with members with varying levels of education, health literacy and understanding.


• Demonstrated ability to interact with providers and members to positively impact the quality of patient care.


• Demonstrated ability to review health care delivery against established criteria.


• Ability to manage multiple projects in conjunction with caseload.


• Demonstrated ability to pro-actively identify problems, as well as recommend and/or implement effective solutions.


• Flexibility to adapt to a changing and fast-paced environment.


• Demonstrated ability to work with and maintain confidential information.


• Demonstrated ability to provide excellent customer service and develop relationships both internally and externally.


• Must have access to reliable transportation to all CDPHP service areas to deliver service to members during regular business hours, evenings and possibly weekends. If driving vehicle for CDPHP business, employee must have valid driver's license, current inspection and appropriate insurance coverage in effect at all times.


• Ability to speak Spanish or another language preferable.

As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, protected veterans status, or any other characteristics protected under applicable law. To that end, all qualified applicants will receive consideration for employment without regard to any such protected status.

CDPHP and its family of companies include subsidiaries Acuitas Health LLC, Strategic Solutions Management Consultants (SSMC), Practice Support Solutions (PSS), and ConnectRX Services, LLC.

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