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Provides care coordination to members with behavioral health conditions identified and assessed as requiring intensive interventions and oversight including multiple, clinical, social and community resources. This role promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member satisfaction.
- Conducting in depth health risk assessment and/or comprehensive needs assessment which includes, but is not limited to psycho-social, physical, medical, behavioral, environmental, and financial parameters.
- Communicating and developing the treatment plan for authorization of services, and serves as point of contact to ensure services are rendered appropriately, (i.e. during transition to home care, back up plans, community based services).
- Implementing, coordinating, and monitoring strategies for members and families to improve health and quality of life outcomes. Develops, documents and implements plan which provides appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs. Acts as an advocate for members care needs by identifying and addressing gaps in care. Performs ongoing monitoring of the plan of care to evaluate effectiveness. Measures the effectiveness of interventions as identified in the members care plan
- Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes; collects clinical path variance data that indicates potential areas for improvement of case and services provided; works with members and the interdisciplinary care plan team to adjust plan of care, when necessary.
- Educating providers, supporting staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care. Facilitates a team approach to the coordination and cost effective delivery to quality care and services.
- Facilitates a team approach, including the Interdisciplinary Care Plan team (ICPT), to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum. Collaborates with the interdisciplinary care plan team which may include member, caregivers, member?s legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care services. Utilizes licensed care coordination staff as appropriate for complex cases.
- Provides assistance to members with questions and concerns regarding care, providers or delivery system.
- Maintains professional relationship with external stakeholders, such as inpatient, outpatient and community resources.
- Generates reports in accordance with care coordination goals.
- Complies with Case management Society of America Standards for Case Management Practice and with CCMC code of Professional Conduct for Case Managers.
- Assists with orientation and mentoring of new team members as appropriate.
This is a REMOTE position after the 3 week on site training at the Columbia, MD location.
Candidates don’t have to have a landline, but they need to connect to their network (Ethernet) and not use Wi-Fi at home.
The candidates submitted to this req MUST reside in DC AND hold a MD license. This candidate MUST be dual licensed; DC & MD.
To avoid duplicate submittals with the FTE recruitment, please ask your candidates if they have applied for the FT position
The annual salary if hired Magellan FTE is $70K
The candidate must be able to type and talk at the same time at a conversational pace and able to navigate through multiple systems.
!!!When submitting the resume - PLEASE submit a note with the Typing Scores (WPM) and Excel Scores!!!
Your candidate MUST have 5 TOTAL years of Post Masters Experience. So, if there is a gap in employment, that time WILL NOT be included in the 5 years. This is NOT a Magellan requirement. This is there customer’s requirement.
There is a team of roughly 70. These candidates will be in a cube setting working from the phone. The calls can last 30+ mins depending on the nature of the call. They will receive the calls from the Care Workers and will assess the needs and determine the best resources. There will be follow up calls HOURS: 1 weekend day (either Sat 9-2 or Sun 12-5) and 1 late night during the week (Mon-Thurs until 9 pm) OR 2 late nights during the week (Mon-Thurs until 9 pm) with NO WEEKEND work. The work schedule WILL NOT be adjusted. After the training a schedule will be developed for the worker. Training is 3 weeks Mon – Fri from 8:30 am – 5:00. However, the candidate will be assigned his/her fixed work schedule between the 4th and 6th week on the assignment. COMPUTER LITERATE: Must be computer literate. Must be comfortable with Microsoft Office and know how to send and receive an e-mail, attach a document, accept meeting invites, work in Word, Excel (be able to sort and filter data). Not a lot in PowerPoint. They are HEAVY IM and email users so they must be familiar. The candidate MUST be able to type and talk at the same time. ADDTIONAL INFO: The managers will conduct in-person interviews. If the candidate has a successful interview with the hiring manager, then he/she will then interview with their client. Both interviews will be in person. This is the process: I will be notified by the Management Team with available Care First interview dates and times. I will then contact you for your candidate's contact information (phone number and email) so that I can have a conversation with him/her with the available days and times and STRONGLY encourage him/her to be flexible. Your candidate will select ALL times that he/she is available. I will report that to the Management Team, the Management Team will get a confirmed interview day and time from Care First and then I will contact your candidate and confirm the interview. You will see a confirmation in the tool and an email will be sent to you displaying the confirmed interview. Please let me know if you have any question on this. My email: firstname.lastname@example.org If your candidate is extended an offer, he/she will need to complete one of the credentialing packets based on the residing state (attached to this req) in addition to the enrollment paperwork AND the candidate needs to register for NPI# prior to the start of the assignment. The details on how to register for that will be sent once the offer is accepted This is Temp To Hire with annual bonus potential for full time employees. EXPERIENCE: They need a Masters level behavioral health clinician with 5 years’ post master experience that is licensed to practice independently. They MUST the license in Maryland, but they are also looking for candidates who hold a license in VA and/or DC in addition to the MD license. Licensed as a LCSW-C or LCPC or LCMFT- Do not submit a candidate over $50.68. The system will deduct the 2.4%. The mark up between the Resource and Supplier should not exceed 50.50%
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