Behavioral Health Coach - Pediatric (Remote)

Company :

Highmark Inc.

Job Description : 

JOB SUMMARY

This job assures that members with medical and psychosocial needs have access to high quality, cost-effective health care. This role supports members through motivational enhancement by developing goals, self-management skills and behaviors that impact well-being and lifestyle changes. The incumbent will also encourage engagement in low intensity interventions. This is accomplished by assisting in the initial screening, identifying gaps in care and barriers to adherence, goal setting, planning, arranging, coordinating, necessary to facilitate member access to healthcare services and community resources. Conducting accurate planning, and collaborating with internal and/or external customers and contacts. Following established regulatory guidelines, policies, and procedures in relation to member interventions and documentation of activities related to the member’s care and progress across the continuum of care. Facilitating and/or participating in interdisciplinary and/or interagency meetings, when necessary, to facilitate coordination of services/resources for members. The overall goal is to help members navigate the health care system and develop condition self-management skills through behavior change.

ESSENTIAL RESPONSIBILITIES

• Communicate effectively while performing customer telephonic motivational interviewing  with external contacts.  Educate members in order to enhance member understanding of illness/disease impact and to positively impact member care plan adherence, pharmacy regimen maintenance, and health outcomes including health behavior changes.
• Collaborate with Case Management Specialists, Management Team, Physician Advisors, Primary Care Physicians, Medical Specialists, Home Health and other ancillary healthcare providers with the goal being to coordinate member care.
• Collect member medical information from a variety of sources including providers and internal records and use appropriate clinical judgment, consultation with internal Physician Advisors and other internal cross-departmental consultation to determine unmet member needs. Maintain a working knowledge of available resources for addressing identified member needs and to facilitate proactive and efficient provision of services.
• Attend and participate in required meetings, interagency and/or interdisciplinary team meetings, including staff meetings, internal rounds, and other in-services in order to enhance professional knowledge and competency for overall management of members.  Participate in departmental and/or organizational work and quality initiative teams.  Attend internal and external continuing education forums annually to enhance overall clinical skills and maintain professional licensure, if applicable.
• Educate health team colleagues of the role and responsibility of Case Management and the unique needs of the populations served in order to foster constructive and collaborative solutions to meet member needs.
• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor's Degree in Psychology, Social Work Health Education or other Human Services related field.

Substitutions

• 6 years of related and progressive experience in the Behavioral Health field in lieu of Bachelor's Degree.

Preferred

• Master's Degree in Psychology, Social Work, Counseling, Marriage and Family Therapy,, Health Education or other Human Services related field.

EXPERIENCE

Required

• 3 years  experience in Behavioral Health and/or Substance Use roles.

Preferred

• Prior experience in a managed care setting.

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• Board Certified Coach

SKILLS

• Ability to manage critical conversations
• Effective communication skills (listening, verbal and written)
• Comfort in leading one-on-on conversations while practicing clinical and motivational interviewing skills
• Capacity to work under pressure
• Ability to identify risk and gaps in care

Language (Other than English):

Bilingual Preferred

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Remote  

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