Health Resource Consultant, DCoE
Maryland Heights MO 63043 St Louis 1 14100 Magellan Plaza
Educates member during outreach process about the In-Transition Program. Enrolls member into the program and conducts initial assessment with members utilizing motivational interviewing techniques to assist and guide member through assessment process. Identifies immediate needs and provides necessary resources during initial assessment. Assigns member to coach established by the member. Participates in quality improvement projects to support coaching program. Manages a caseload of members as assigned. May be assigned additional special responsibilities commensurate with experience. Will be expected to coach and mentor less experienced contsultants.
- Conducts initial interview with members through use of motivational interviewing to identify targeted area of focus and develop action plan to improve overall functioning of impairments related to targeted area. Provides outreach to identified members through various resources, inbound and outbound engagement of member explaining program overview, benefits and enrollment into the coaching program. Establishes immediate needs and assists with referrals and resources as needed until ongoing coaching begins. Schedules initial coaching session with identified clinical coach.
- Establishes rapport, educates on program and completes enrollment process. Documents activities in clinical system for accuracy of record keeping and reporting for customer needs. Works with member to develop initial plan of action to include specific areas of change, using UBPAP identified goals and motivational interviewing to engage member during the initial needs assessment process and enrollment process. Provides relevant community resources to support goal plan or resource materials to assist in meeting objectives.
- Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, VA and Tricare resources and services and Magellan Health Services policies and procedures, and criteria.
- Interacts with company supervisory staff to discuss concerns regarding specific cases.
- Participates in quality improvement activities, including data collection, tracking, and analysis.
- Leads or participates in activities as requested that help improve Center of Excellence performance, excellence and culture. Supports team members and participates in team activities to help build a high-performance team. Demonstrates flexibility in areas such as job duties and schedule in order to aid in better serving its members and help the company achieve its business and operational goals. Assists in efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.
- Maintains an active work load in accordance with coaching performance standards. Works with community agencies as appropriate. Collaborates with referral sources. Assists network by identifying gaps in the network and quality providers. Advocates for the member to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process.
General Job Information
TitleHealth Resource Consultant, DCoE
Job FamilyClinical Services Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date6/5/2019
Date Requisition Created6/3/2019
License and Certifications - RequiredLCSW - Licensed Clinical Social Worker - Care Mgmt, LPCC - Licensed Professional Clinical Counselor - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt
License and Certifications - PreferredCEAP - Certified Employee Assistance Professional - Care Mgmt
Other Job Requirements
Responsibilities3 yrs experience post degree in psychiatric and/ or substance abuse health care setting, including utilization review.Field(s) of study: RN, Masters, or Doctoral Degree in behavioral health related fieldGood organizational skills, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community resources and providers. Knowledge and experience in inpatient setting. Ability to function independently and as a team member. Knowledge of DSM IV or most current diagnostic edition. Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care.Ability to use computer systems. Licenses, Certifications, etc.: RN licence at. a minimum. Meets Magellan credentialing requirements for independent professional practice IF performing TRF reviews (Masters level licensed behavioral health professional). CEAP certification as required by management.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.
“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.”