Behavioral Health 24/7 Clinical Navigation and Support Care Manager - Evernorth Health Services - Remote

Our mission is to provide personalized, real-time care navigation and support within the complex behavioral healthcare system.  Through clinical expertise and compassionate guidance, we shepherd individuals to the right care at the right time, empowering them through engagement, education, and evidence-based solutions on their behavioral health journey.  This team was developed to simplify the behavioral health navigation experience.

Our licensed clinicians are available to handle a behavioral crisis, complex navigation needs or clinical care questions with empathy and understanding. The team creates an in-the-moment clinical connection for customers around the clock, 365 days a year. Clinical consultations can be as short as 20 minutes or can last up to 60 minutes. Each clinical situation is unique and will require a flexible approach with the individual and circumstances.  During this consultation, clinicians will address in the moment needs of the customer, assess for risk of harm, provide solution focused, evidence-based interventions, create a plan of action, refer to appropriate resources, and continue to follow-up, when and as long as needed.  We will handle navigation from the in-the-moment need through to resolution. The Clinical Navigation & Support team provides members, and their families with a personal navigation experience that is seamless, efficient and heartfelt. Our goal is to help customers navigate the complex mental health system, getting them the right care at the right time.

The successful candidate will have demonstrated clinical excellence with mental health, substance use disorders, crisis call work, case management and solution focused therapy with a passion to deliver a service experience that exceeds the customer or provider’s expectation. The team works in a fast-paced environment, on a queue, taking telephonic calls in the moment, as well as scheduled calendar appointments.  The team is staffed 24/7 in support of the full organization.   

The CM performs some or all of the following functions:

• Clinical case assessment of needs and crisis risk assessment

• Employee Assistance Consultation (EAC) for employer

• Employee Assistance Telephonic Consultation for employees and members of household

• Behavioral Telephonic Consultation

• Confide Services assessment

• Brief Case Management

Duties and Responsibilities:

• Assess the customer’s immediate risk and need, and provide clinically appropriate referrals for care and treatment

• De-escalate and safety planning

• Use clinical expertise, professional judgment and best practice

• Determine the biopsychosocial need(s) of the customer

• Provides customers with solutions and next steps

• Assist customers with navigating access to care

• Perform research for community and educational resources to assist customers in their journey when needed or refer to Community Support Program

• Educate customers about their benefit plan coverage, how to access coverage via digital application and platforms

• Partner with peers and leaders promoting and embracing a culture of change; supporting all parties through the change process 

• Demonstrate the ability to be agile and flexible in their work process.

• Deliver excellent clinical judgment and interpersonal communication skills

• Exemplify diplomacy with customers and providers who may not be receptive to the information shared

• Understand confidentiality and privacy regulations

• Demonstrate excellent verbal and written communication

Qualifications:

• Requires a Master’s degree or PhD in a mental health field with a current independent licensure in the state of employment (LPC, LMHC, LCSW, LMFT, RN or LP).

• 5 plus years post licensure and experience as a mental health and/or substance use clinician with demonstrated understanding of multiple therapeutic modalities, including brief therapy and managed care experience preferred.

• Knowledge and experience with Employee Assistance Programs (EAP).  

• CEAP certification optional.

• Knowledge and experience with the application of ASAM®, MCG ®, and LOCUS/CALOCUS ® criteria preferred.

• Spanish speaking preferred

• Proficient with multiple software and system applications.

• Demonstrated ability to set priorities including, but not limited to time management and organizational skills

• Passion for integrated health care approach to improve physical and emotional functioning

REQUIRED WORK HOURS:

Full time job with a minimum