Cambia Health Solutions Hiring for Behavioral Health Care Management Clinician – R-4089-4185 at Lewiston, Idaho Full Time

This job was posted by https://idahoworks.gov : For more information,
please see: https://idahoworks.gov/jobs/2057794

Behavioral Health Care Management Clinician

Remote within ID, OR, WA, UT

Primary Job Purpose

The Behavioral Health Care Management Clinician provides clinical care
management (such as case management, disease management, and/or care
coordination) to best meet the member’s specific healthcare needs and
to promote quality and cost-effective outcomes. Oversees a collaborative
process with the member and those involved in the member’s care to
assess, plan, implement, coordinate, monitor and evaluate care as
needed.

General Functions and Outcomes

• Responsible for essential activities of case management including
  assessment, planning, implementation, coordination, monitoring and
  evaluation.
• Assessment: collection of in-depth information about a member’s
  situation and functioning to identify individual needs.
• Planning: identification of specific objectives, goals, and actions
  designed to meet the member’s needs as identified in the
  assessment.
• Implementation: execution of the specific case management activities
  that will lead to accomplishing the goals set forth in the plan.
• Coordination: organization, securing, integrating and modifying
  resources.
• Monitoring: gathering sufficient information to determine the
  plan’s effectiveness and the evaluation phase should determine the
  effectiveness of reaching the desired outcomes. Applies clinical
  expertise and judgment to ensure compliance with medical policy,
  medical necessity guidelines, and accepted standards of care.
  Utilizes evidence-based criteria that incorporates current and
  validated clinical research findings. Practices within the scope of
  their license.
• Consults with physician advisors to ensure clinically appropriate
  determinations.
• Serves as a resource to internal and external customers.
• Collaborates with other departments to resolve claims, quality of
  care, member or provider issues.
• Identifies problems or needed changes, recommends resolution, and
  participates in quality improvement efforts.
• Responds in writing or by phone to members, providers and regulatory
  organizations in a professional manner while protecting
  confidentiality of sensitive documents and issues.
• Provides consistent and accurate documentation.
• Plans, organizes and prioritizes assignments to comply with
  performance standards, corporate goals, and established timelines.

Minimum Requirements

• Knowledge of health insurance industry trends, technology and
  contractual arrangements.
• General computer skills (including use of Microsoft Office, Outlook,
  internet search). Familiarity with health care documentation
  systems.
• Strong oral, written and interpersonal communication and customer
  service skills.
• Ability to interpret policies and procedures, make decisions, and
  communicate complex topics effectively.
• Strong organization and time management skills with the ability to
  manage workload independently.
• Ability to think critically and make decision within individual role
  and responsibility.

Normally to be proficient in the competencies listed above

Behavioral Health Care Management Clinician would have a Bachelor’s
Degree in Nursing or related field and 3 years of case management,
utilization management, disease management, or behavioral health case
management experience or equivalent combination of education and
experience.

Required Licenses, Certifications, Registration, Etc.

Must have licensure or certification, in a state or territory of the
United States, in a health or human services discipline that allows the
professional to conduct an assessment independently as permitted within
the scope of practice for the discipline (e.g. medical vs. behavioral
health) and at least 3 years (or full time equivalent) of direct
clinical care

Must have at least one of the following:

• Bachelor’s degree (or higher) in a health or human services-related
  field (psychiatric RN or Master’s degree in Behavioral Health
  preferred)
• Registered nurse (RN) license (must have a current unrestricted RN
  license for medical care management)

#LI-remote

The base pay annual pay range for this job is $35.10 – $47.60. The
bonus target for this position is 10%.

Base pay is just part of the compensation package at Cambia that is
supplemented with an exceptional 401(k) match, bonus opportunity and
other benefits. In keeping with our Cause and vision, we offer
comprehensive well-being programs and benefits, which we periodically
update to stay current. Some highlights:

medical, dental, and vision coverage for employees and their eligible
family members

annual employer contribution to a health savings account ($1,200 or
$2,500 depending on medical coverage, prorated based on hire date)

paid time off varying by role and tenure