Behavioral Health Case Manager
Comagine Health
- Remote, OR
- $71,000-88,000 per year
- Permanent
- Full-time
- Conducts initial, annual, and as needed face-to-face assessments to create and maintain a tailored PCSP, utilizing LOCUS, the LSI, and review of records.
- Provides advocacy to individuals (and authorized representatives and supports) regarding assessment, patient-centered service planning, service coordination, and transition planning.
- Assists in eligibility determinations as needed.
- Works closely with individuals, providers, facilities, and social service and community organizations to assist individuals in accessing appropriate care.
- Ensures care is being delivered as described in the PCSP, working with providers and individuals to correct services or adjust the PCSP as needed.
- Performs prior authorizations for services.
- Applies clinical review criteria, guidelines, and screens to determine the medical necessity of health care services.
- Consults with physicians or practitioner consultants when reviews fail clinical review criteria, guidelines, and screens
- Follow all determinations, appeals and hearings policies, processes, and contract requirements.
- Demonstrated ability to conduct a behavioral health assessment including the identification of precipitating events, including health and safety risks to self or others.
- Competent in gathering histories of mental and physical health, substance use, and criminal justice system.
- Ability to conduct a mental status examination.
- Competent in providing DSM 5 diagnoses.
- Proficient in developing treatment plans and safety plans.
- Graduate degree in social work, psychology, or other behavioral health science field or Bachelor’s degree in nursing and licensed by the State of Oregon (with relevant training in behavioral health service delivery).
- Qualified Mental Health Professional (QMHP) with designation (QMHP-C or QMHP-R) or provide proof of QMHP application at the time an offer is extended, and certification is obtained within 2 weeks following date of employment; or current, active, unrestricted clinical licensure required.
- 2 year's of experience working with individuals with severe and persistent mental illness.
- Candidates must reside in the geographic area and be willing to travel in their personal vehicle up to 50% of the time to perform in person assessments. Ideally candidates will reside in the Portland metro area with travel of up to 50% throughout the region.
- Oregon Medicaid knowledge, and knowledge of Oregon Health Plan’s Prioritized List of Health Services preferred.