Case Manager

San Diego CA 92108

Job Description

This position is responsible for the assessment, reassessment, care planning and coordination of care and services for Members enrolled in the case management program. Includes ongoing monitoring of an appropriate and effective person centered care plan, member education and care coordination. Regularly communicates with the member’s PCP and other providers, and integrates the member, caregiver and other provider feedback into the assessment and planning.
  • Maintains a caseload of members enrolled in the case management program, including risk stratification of members, monitoring reassessment needs and facilitating transitions of care settings.
  • Serves as the primary point of contact throughout the treatment episode at the levels of care.
  • Coordinates with the interdisciplinary team of providers, vendors, facilities, discharge planners, nurses, social workers, care coordinators, and member/caregivers to effectively manage care plans and transitions of care settings.
  • Maintains timely, complete and accurate documentation in compliance with regulatory policies and procedures.
  • Participates in complex case rounds and/or meetings and consults with Physician Adviser/Medical Director on regular basis concerning the progress of members.
  • Provides consultation to PCP/Providers as indicated with consent of client. Identifies barriers to accessing services and assists members as needed.
  • Participate actively in the Quality Improvement program.
  • Other duties as assigned.

General Job Information

Title

Case Manager

Grade

22

Job Family

Clinical Services Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

1/29/2019

Date Requisition Created

1/28/2019

Minimum Qualifications

Education

Masters (Required)

License and Certifications - Required

Current licensure required for this position that meets State, Commonwealth or customer-specific requirements. - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LPCC - Licensed Professional Clinical Counselor - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt

License and Certifications - Preferred

CCM - Certified Case Manager - Care Mgmt

Other Job Requirements

Responsibilities

  • Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements. 
  • One or more of the following licensure is required for this role with necessary degrees:  CEAP, LMFT, LCSW, LPC.
  • Minimum 2 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care setting.
  • Strong organization, time management and communication skills.
  • Knowledge of utilization management procedures, mental health and substance abuse community resources and providers.
  • Knowledge and experience in inpatient and/or outpatient setting.
  • Knowledge of DSM V or most current diagnostic edition.
  • Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled

“I receive a high level of support from our Senior Management Team to execute on our vision. They are always accessible and approachable, something I’ve found to be very unique to Magellan.”