Behavioral Health Social Work Case Manager (U.S. Remote)

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company’s mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra seeks a Social Worker Case Manager to join our growing team.

** Contractually Required Work Hours:  Monday - Friday 8:00 AM to 5:00 PM Pacific. **

** This is a full-time, direct hire, exempt (salary), remote-based opportunity with Benefits. **

The Social Worker Case Manager will: 

• Provide telephonic care coordination in the state of Oregon from a remote setting. An integrated care management model (including care coordination/case management) is used to assist the Community Mental Health Program (CMHP)/Behavioral Health Care Coordination with assessing member-related social needs. This program includes Medicaid-eligible, Open Card, and Coordinated Care Organization (CCO) populations who may have special needs and considerations given their current health treatment and/or needs.

• Foster an environment that incorporates all aspects of the care management process and coordinates care with the beneficiary to stabilize their health status to maximize their functional capacity and improve overall quality of life.
• Be responsible for outreach, assessing, planning, implementing, case manager referrals for processing, referrals for care, and evaluating options and services to affect an appropriate, individualized plan for the beneficiary across the continuum of care.
• Facilitate, coordinate, integrate, and manage integrated case management and disease management activities based on the Case Management Society of America (CMSA) definition, philosophy, and guiding principles for case management.
• Provide comprehensive assessments and periodic reassessment of individual needs to determine the need for medical, educational, social, or other services.

• Outreach assigned members to coordinate all care needs, ensure utilization of interpreter services for appointments, coordinate benefits, and facilitate warm hand-off notifications to all necessary stakeholders.
• Provide communication activities including, but not limited to, face-to-face meetings, telephone interactions, caregiver interactions, rounds, interdisciplinary team meetings, and other related evidence-based practices.
• Coordinate referrals and related activities (such as scheduling appointments for the individual) to help the eligible individual obtain needed services.
• Ensure quality-driven outcomes through best practices and motivational interviewing. 
• Ensure accuracy and timeliness of all applicable review-type cases within contract requirements.
• Always maintain medical records confidentiality through proper use of computer passwords, maintenance of secured files, and adherence to HIPAA policies.
• Attend training and scheduled meetings to maintain and use current/updated information for review.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary per contractual requirements.

Job Responsibilities:

• Outreach to assigned members based on access or lack of access to Behavioral Healthcare.
• Coordinate health and social services, coach the beneficiary and families, advocate for the beneficiary, educate the beneficiary and family, clarify and assist with physician’s care plans, and communicate status and plans among the care team and resources, as indicated.
• Use independent social worker judgment and discretion to address, resolve, and process problems impeding the treatment plan.
• Seek consultation from community physicians, specialists, pharmacists, and other disciplines to facilitate care to optimize beneficiary function or prevent further decline in health.
• Develop beneficiary-centered care plans demonstrating shared accountability between beneficiaries, caregivers, and providers, as necessary.
• Review the care plan and progress in regular care conferences, emphasize transitions to other programs, and teach self-management/family caregiver management of chronic conditions to optimize funct