Clinical Case Manager BH Field - Passaic, Morris, & Surrounding counties

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Position Summary

This is a remote Clinical Case Manager opportunity with 50 to 75% field travel in Passaic, Morris, and surrounding counties. The working schedule is Monday - Friday 8am-5pm EST.

Job description:   

Develop, implement, support, and promote health service strategies, tactics, policies, and programs that drive the delivery of quality healthcare to our members. Health service strategies, policies, and programs are comprised of utilization management, quality management, network management, clinical coverage and policies. The position requires advanced clinical judgment and critical thinking skills in order to facilitate appropriate physical, behavioral health, psychosocial wrap around services. The care manager will be responsible for, care planning, direct provider collaboration, and effective utilization of available resources in a cost-effective manner. Strong assessment, writing and communication skills are required.  

Fundamental Components/Job Description:  

The Clinical Case Manager BH is responsible for conducting face to face visits using comprehensive assessments of members enrolled in Managed Long-Term Services and Supports program (MLTSS) and/or Dual Special Needs Program (D-SNP/ FIDE). Care manager may also be responsible for face to face assessments with non-MLTSS members to evaluate the medical needs of the member to facilitate the member’s overall wellness and help them obtain the services they need to thrive by addressing requests for services such as adult medical daycare, pediatric medical daycare, personal care assistant, nursing facility custodial requests, personal preference program and MLTSS program enrollment. Successful completion of company sponsored NJ Choice Certification is requirement for continued employment. The care manager is responsible to coordinate and collaborate care with member/authorized representative, PCP, and any other care team participant. The care manager will attend interdisciplinary meetings and advocate on members behalf. The care manager works with member and care team to develop care plan and will authorize services within the MLTSS/ FIDE benefit. The care manager will also work with the member and care team to coordinate and assist with community resources. The care manager is responsible for documenting accurately and timely in the electronic health record. This position requires the care manager to use critical thinking and be able to problem solve any issues related to assigned membership. While this position is tele-work the care manager must work normal business hours.  The Case Manager will also be expected, to mentor new hires, once, a level of proficiency has been attained in their role. 50 to 75% travel in Passaic/ Morris and surrounding counties. 

Required Qualifications

• Active Behavioral Health license in NJ such as LCSW, LSW, LPC, LPCC, LMFT

• 2+ years Behavioral Health experience/expertise

• Willing and able to travel 50 to 75% in Passaic, Morris County and surrounding counties

• Must reside in Passaic, Morris, or an adjacent county  

• 2+ years of experience working with MS office applications such as Teams, Outlook, Excel, and Word

• Successful completion of the NJ Choice certification is a contingency of employment. As per NJ Division of Aging Services, Office of Community Choice Options guidance, an exam score of 80% or higher is required, along with successful completion of the State training modules, and field mentoring component.  

Preferred Qualifications

• Preference for candidates who reside in Passaic County

• Case management and/or discharge planning experience

• Managed Care experience

• Crisis i