Apply on Employer Site

Blue Shield of California · 4 weeks ago

Behavioral Health Care Mgmt Clinician, Senior (RN ONLY)

AZ, United States

Full-time

Onsite

Mid, Senior Level

$89K/yr - $134K/yr

5+ years exp

Blue Shield of California is seeking a Senior Behavioral Health Care Management Clinician to assist members with behavioral health needs in navigating the healthcare system. The role involves assessing emotional and psychological well-being, providing resource coordination, crisis intervention, and collaborating with healthcare providers to support treatment plans.

Financial ServicesHealth InsuranceNon Profit

No H1B

Responsibilities

Collaborate with case managers and other team members to complete member assessments related to social and resource needs to support member access to services

Collaborate with service coordination staff and act as liaison to ensure a timely and accurate response to member needs

Collaborate with providers to support members’ treatment plan and care needs

Recognize the client’s right to self-determination as it relates to the ethical principle of autonomy, including the client/family's right to make informed choices that may not promote the best outcomes, as determined by the healthcare team

Assess members health behaviors, cultural influences and clients belief/value system and evaluates all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriers

Efficiently manages and maintains a caseload of members for behavioral health care coordination and or BH case management for persons experiencing severe and persistent mental illness

Maintains an active workload in accordance with National Care Manager performance standards

Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria

Interacts with Utilization department and Physician Advisors to discuss clinical questions and concerns regarding specific cases

Coordinates services with state and community programs on behalf of the member, particularly when the member is unable to effectively do so independently

As a mandated reporter, files and follows-up on reports made to the appropriate government agency (e.g., Adult Protective Services, Child Protective Services, etc.)

Actively participates in Interdisciplinary Team Meetings and case consultations with Licensed Manager

Qualification

CA RN LicenseCertified Case ManagerManaged care experiencePsychosocial assessmentsHealthcare delivery systemsCare coordinationMicrosoft OfficeCommunication skills

Required

Requires a current and valid CA RN License or valid RN license(s) from other state(s). Preferred licensure from a compact state. If assigned to another state, you must maintain an active, unrestricted RN license in assigned state(s) or the ability to obtain required RN license (in addition to primary state license) within 90 days of hire

Requires 5 years of experience in nursing, healthcare, or related field

Strong knowledge of healthcare delivery systems, managed care principles, and care coordination

Excellent communication skills

Experience conducting thorough psychosocial assessments, developing care plans and providing necessary interventions identified during assessment with complex client populations that may have, among other things, inadequate coping skills, severe emotional disorders, developmental disabilities, mental illnesses, and/or unstable housing

Considerable knowledge of a wide range of psychosocial challenges and familiarity with behavioral health diagnoses and treatment

Proficient with computer programs such as Microsoft Excel, Outlook, Word, and PowerPoint