Clinical Care Manager - Integrated Care for Kids CBCM

The Clinical Care Manager is responsible for care coordination population management crosssystem consultation provider management treatment quality monitoring and potentially utilization management. The Clinical Care Manager must utilize clinical knowledge of best practices and evidencebased treatments to ensure CBH members receive timely access to quality medically necessary behavioral health services.

When clinically indicated Clinical Care Managers consult with CBH Physician and Psychologist Advisors to ensure the most effective treatment for the CBH member is being authorized. The Clinical Care Manager will work to enhance physical and behavioral health care coordination and assist with mitigating social determinants of health (SDOH).

Essential Functions:

• Be knowledgeable about behavioral health care services system partners service continuum and established medical necessity criteria and apply that knowledge in all work activities.
• Work directly with members natural supports and providers in the community.
• Facilitate care coordination. Using an intergenerational approach with system partners to address social determinants barriers to wellness and other needs of members including connection to appropriate community based services.
• Complete Utilization Management activities including but not limited to: interagency meetings social determinants interviews with members treatment team meetings case consultations care coordination provider meetings reviews treatment linkage.
• Complete expected number of care coordination and/or UM activities per day/shift as specified under team specified under team specific responsibilities in established timeframes.
• Authorize treatment when Medical Necessity Criteria is met.
• Consult with Physician Advisor Psychologist Advisor and/or Clinical Leadership as clinically appropriate.
• Demonstrate an understanding of EvidenceBased Practices (EBPs) and connect members to appropriate evidencebased treatment.
• Collaborate with other CBH departments to ensure quality of care promote placement of members in the most appropriate services andto facilitate consistent longitudinal care management.
• Document provider quality concerns in accordance with CBH policy/procedure.
• Conduct provider and/or stakeholder meetings at least quarterly.
• Use data to inform clinical decisionmaking.
• Maintain documentation in CBHs electronic system consistent with agency and industry standards.
• Respond to care coordination correspondence within 2448 hours or sooner if necessary.
• Work collaboratively with the onsite interdisciplinary team.
• Attend all meetings as assigned and actively prepare for and participate in supervision and clinical case consultations.
• Ensure highest quality of customer service when interacting with members providers and other stakeholders.
• Display commitment to member and family driven care and principles of resiliency and recovery.
• Generate denial letters based on physician reviews and in accordance with state regulations as needed.
• Contribute to projects and other duties as assigned.

Team Specific Responsibilities:

• Complete an average of 815 care coordination/UM activities per day.
• Facilitate care coordination with externalstakeholders and system partners and providers.
• Complete documentation and plans to promote collaboration with physical health providers and system partners.
• Complete majority of these team specific activities while colocated in a hospital and/or primary care setting

Position Requirements:

• Education: Masters degree in Social Work or related field
• Clinical Licensure: Qualified candidates are required to obtain license within the first 18 months 1.5 years) of employment; PA Child Abuse Clearance required
• Required Licensure: Licensed Social Worker (LSW) Licensed Professional Counselor (LPC) Licensed Marriage and Family Therapist (LMFT) Licensed Clinical Social Worker (LCSW)
• Community Based/Clinic Setting experience.
• Strong communication skills
• Relevant Work Experience: Minimum of 3 years of direct clinical care experience working with adults children adolescents and/or their families in behavioral health settings and experience in assessment and treatment planning; and/or experience in a managed care setting

Skills:

• Excellent clinical case conceptualization skills
• Meeting facilitation
• Proactive planning
• Customer service
• Familiar with medications
• Excellent verbal and written communication skills and ability to use them when communicating with internal and external stakeholders.
• Excellent interpersonal and collaboration skills
• Proficient in MS Office especially with Excel and able to type at least 40 words per minute
• Ability to work independently and as part of a team
• Excellent time management and prioritization skills and ability to multitask
• Compliant with HIPAA regulations

Work Conditions (including travel overtime required physical requirements and occupational exposure):

• Must be able to travel within Philadelphia and surrounding counties.
• Regularly requires walking standing stooping bending sitting reaching pushing pulling and/or repetitive wrist/hand movements for various lengths of time throughout the day.
• Ability to utilize computers and office equipment to complete daily work responsibilities.
• Regularly works inside in areas that are adequately lighted and ventilated. Some fluctuation in temperature. No protective equipment routinely needed.
• Must be able to adapt to continuous changes/demands of the job.

Philadelphia Residency Requirement:

• The successful candidate must be a current Philadelphia resident or become a resident within six months of hire.

Equal Employment Opportunity:

• We strive to promote and sustain a culture of diversity inclusion and belonging every day. CBH is an equal opportunity employer. We do not discriminate in recruiting hiring promotion or any other personnel action based on all qualified individuals. This is without regard to race ethnicity creed color religion national origin age sex/gender marital status gender identity sexual orientation gender identity or expression disability protected veteran status genetic information or any other characteristic protected individual genetic information or nondisqualifying physical or mental handicap or disability in each aspect of the human resources function by applicable federal state or local law.

Requesting An Accommodation:

• CBH is committed to providing equal employment opportunities for individuals with disabilities or religious observance including reasonable accommodation when needed. If you are hired by CBH and require an accommodation to perform the essential functions of your role you will be asked to participate in our accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodation once hired.
• If you would like to be considered for employment opportunities with CBH and have accommodation needs for a disability or religious observance please send us an email at