Behavioral Health Clinical Specialist, Redding, CA
Behavioral Health Clinical Specialist
Job Locations US-CA-Redding
Job ID 2019-1584
Category Health Services
Under direction, develops, implements, and coordinates medically necessary treatment services within PHC’s Health Services for adults and children with behavioral health and/or substance use disorder needs. Collaborates and coordinates care as part of the multidisciplinary team to evaluate and advocate for the medical, behavioral and psychosocial needs of the member while promoting quality and cost-effective outcomes.
*This position requires substance use disorder experience.
- Independently conducts and documents accurate and thorough assessments to identify the member/family medical, behavioral health and/or psychosocial needs; documents goals, progress and outcomes.
- Analyzes member needs, impairments and behaviors; analyzes factors associated with mental illness which may exert an adverse effect upon health status, treatment adherence or recovery.
- Reviews treatment authorization requests for medically necessary services in accordance with PHC policies and procedures.
- Collects and records social and psychiatric information for assessment and evaluation of treatment needs.
- Coordinates with health clinics, providers, caseworkers, probation officers, community and support services and other professionals to obtain information, determine appropriate venue for services and aid the member in obtaining timely and appropriate access to care.
- Collaborates with members and/or the multidisciplinary care team to assist in understanding their physical or mental health needs, their impairments and their response to them, the social and emotional factors related to their illnesses, and stressors interfering with treatment or social functioning while focusing on strengthening the member’s efforts toward their health goals.
- Assists members with paperwork and enrollment for various social support and community resources.
- Participates in developing procedure and informational materials that support PHC services and benefits; conducts and contributes in special training for staff, professionals, public and private agencies and others as identified.
- Attends and participates in a variety of internal and external meetings such as case conferences, inter-agency meetings, health fairs, continuing education or required training sessions when identified.
- Monitors and reviews the plan of care and delivery of service in accordance with PHCs policies.
- Notifies claims department of benefit-related decisions and CM interventions to ensure appropriate payment of approved services.
- Answers and triages department calls, and independently distributes department referrals in accordance with identified department service levels.
- Provides technical guidance and clinical support to Health Services staff.
- Performs other duties as assigned by the supervising Manager, including the assumption of new duties.
Education and Experience
A Master’s Degree as a Clinical Social Worker or Master’s Degree that qualifies for licensure as Marriage and Family Therapist. Two (2) years of experience working as a Licensed Clinical Social Worker, Licensed Marriage and Family Therapist, or Licensed Professional Clinical Counselor. Experience in the delivery of care and services that address social, psychological and physiological needs of individuals from diverse populations. Demonstrated skill in using evidence-based principles, methods and techniques to address mental health and substance use disorders across multiple care settings.
Special Skills, Licenses and Certifications
Possession of a current Licensed Clinical Social Worker (LCSW) License, Marriage and Family Therapist (MFT) License, or Licensed Professional Clinical Counselor (LPCC) issued by the California State Board of Behavioral Science Examiners OR possession of successor licensure recognized as equivalent by the State of California. Considerable knowledge of prevention, treatment and rehabilitation techniques used in the identification and treatment of mental illness and emotional disorders. Federal, state and local laws, rules and regulations associated with mental health treatment and education programs. In depth understanding of the treatment of mental illness, including wellness and recovery as well as strength based approaches for individuals and their families. Valid California driver’s license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business.
Performance Based Competencies
Strong organizational, communication, attention to detail and critically thinking skills required. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines. Ability to apply clinical judgment to complex medical situations and make quick decisions. Effective telephone and computer data entry skills required. Experience in managed care business practices and ability to access data information using computer systems. Excellent English written and verbal communication skills.
Work Environment And Physical Demands
Daily use of the telephone and computer for most of the day. Standard cubicle workstation. Must be able to lift, move, or carry objects of varying size, weighing up to 10lbs.
All HealthPlan employees are expected to:
- Provide the highest possible level of service to clients;
- Promote teamwork and cooperative effort among employees;
- Maintain safe practices; and
- Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.