Behavioral Health Licensed Care Manager, Bakersfield, CA

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Behavioral Health Licensed Care Manager

Kern Family Health Care, 2900 Buck Owens Blvd., Bakersfield, California, United States of America Req #1959

We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a position that meets your objectives and those of the organization. Qualified applicants are considered for positions without regard to race, color, religion, sex (including pregnancy, childbirth and breastfeeding, or any related medical conditions), national origin, ancestry, age, marital or veteran status, sexual orientation, gender identity, genetic information, gender expression, military status, or the presence of a non-job related medical condition or disability (mental or physical).

KHS reasonably expects to pay starting compensation for the position of Behavioral Health Licensed Care Manager in the range of $35.50 – $47.48 hourly.

Our Mission. Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system.

About the role

Under the direction of the Behavioral Health leadership, this position works directly with the BH department and staff from other departments, members, external care managers, and providers in assessing and providing appropriate services to achieve positive health outcomes. Care Management is broadly defined, and can include outreach and engagement to members, engaging members in skilled therapeutic interactions to promote health behaviors, coordination of care, resource linkages, working with other professionals and organizations in the community to ensure quality of care for members, seamless transitions of care, and facilitating the right care and the right time for the member. As a licensed clinician, this position provides clinical expertise, clinical leadership, and clinical oversight in treatment recommendations, case consultation, transitions of care, in addition to responsibility for reviewing and processing requests for authorization and notification of psychological testing and psychiatric services from health professionals, clinical facilities, and ancillary providers. Also, this position will conduct clinical reviews of outpatient authorization requests. This position, like all positions within the Behavioral Health Department, is expected to model behavioral health principles of relationship-based care, as well engage in promoting education and understanding of behavioral health and its importance in whole health, to those within KHS and in the community.

Distinguishing Characteristics

This position is responsible for assigned BH care management functions for KHS, a licensed health maintenance organization (HMO). Specifically, this position maintains clinical expertise and knowledge of best practices for all relevant clinical areas of behavioral health including statutory and regulatory requirements The primary duty of the BH Licensed Care Manager is to work closely with licensed and unlicensed staff to co-manage the care of complex cases telephonically through regular contact with members, caretakers, healthcare professionals and others involved in the member’s care and with the other local agencies focused on mental health, substance use, and special needs. This includes Regional Center and Kern Behavioral Health and Recovery System (KBHRS) to ensure smooth transitions across the continuum of health care and adhere to “No Wrong Door” principles and policies. This position serves as a liaison to KHS member facing departments, behavioral health providers, and members to provide any behavioral health service needs identified for KHS membership.

Essential Duties and Responsibilities

• Skillfully develop therapeutic alliances with members and utilize evidenced based communication skills in assisting members.
• Coordinate with internal and external health partners to support Members’ comprehensive care needs.
• Provide effective Care Management for KHS members, including care coordination, linkage to resources, support in transitions of care, facilitating member self-efficacy and self-management, and all other activities associated with high quality, evidenced-based care management.
• Engage and collaborate with staff outside the BH department, or with those outside BH discipline, to provide integrated care to KHS members.
• Responsible for assisting Members with care coordination needs, including, but not limited to the following:
  • Conduct comprehensive, holistic assessment of members health care status, history, risks, and utilization -both telephonically as well as in person.
  • Assimilate assessment information into an individualized care plan (ICP).
  • Communicate ICP with Member, approved family or caregiver and other Members of the care team.
  • Participate in inter/transdisciplinary care team meetings to share information, update and inform care plan.
  • Coordinate with internal and external health partners to support Members’ comprehensive care needs.
  • Participate and lead (as necessary) care transition plan responsibilities.
• Engage in proactive, member-centered utilization and quality review of Behavioral Health services by members using clinical policies and procedures and nationally recognized evidence-based clinical review guidelines.
• Review ICD-10, CPT-4, and PCPCS codes for accuracy and existence of coverage
• Provide crisis intervention to individuals, as well as providing support and clinical guidance to others who engage in this work.
• Participation in Behavioral Health team and department meetings.
• Model continuous quality improvement philosophy and engage in quality improvement initiatives and projects.
• Provide clinical trainings and other learning and development activities, within areas of expertise, inside and outside the behavioral health department
• Model supportive and collaborative relationships with members, co-workers, and community relations.
• Participate in other committees as needed, or as directed by the BH supervisors, managers or Directors.
• Communicate, as needed, with the Senior BH Director and Director of Behavioral Health to validate patient acuity and plan of care; refer authorization requests for potential denial to the Senior BH Director.
• Engage in all KHS employee training and comply with all KHS policies.
• Commit to advancing equitable behavioral health care across Kern County.
• Establish and maintain effective goodwill relationships with coworkers, supervisors, and other colleagues, and collaboratively work with team members.
• Model the highest ethical behavior in care for members, as well as in relationships with co-workers, supervisors, and colleagues in the community.
• Advocate for members to receive the highest quality care, in a timely manner, within KHS network.
• Performs other job-related duties as required.
• Occasional travel required.
• Adheres to KHS’s Code of Ethics and Business Conduct and all company policies; e.g., confidentiality, attendance, safety/security, use of equipment and technology, appearance and demeanor.

Supervisory Responsibilities

N/A

Candidate Requirements

Education: Master’s degree from an accredited institution required.

Professional Licenses

Active and unrestricted California License as a Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), or Psychiatric Registered Nurse (RN).

Experience: Minimum of 3 years of experience performing or facilitating Behavioral Health services. Experience working successfully within a team and experience in developing and maintaining effective relationships with both clients and coworkers is mandatory.

Preferred Experience: Behavioral Health services experience in a health clinic psychiatric hospital medical facility, or health care clinic strongly preferred. Experience in clinical services, both mental health and substance use preferred. Experience in motivational interviewing and/or other evidenced based communication strategies preferred.

Knowledge Requirement

Familiarity with Managed Care and discharge planning is required. Knowledgeable and skilled in evidenced based communication such as Motivational Interviewing, or similar empathy-based communication strategies. Understanding of and sensitivity to multi-cultural communities. Deep understanding and knowledge of mental health and substance use conditions, including both acute and chronic management. Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both. Knowledge of whole health and integrated principles and practices is preferred.

Skills Requirement

Bilingual (English/Spanish) preferred.
Highly skilled interpersonally, with excellent relationship skills. Highly skilled in interpersonal communication, including resolving conflict with co-workers. Skillful in informally and formally sharing expertise. Must have skills and resilience to tolerate a moderate level of change and development around new models of care and care management practices. Proficient in the use of computer software to include but not limited to: (e.g. Microsoft Word and Excel, Power Point).

We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis.

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