Who We Are

At Lucet, we are industry leaders in behavioral health, dedicated to helping people live healthy, balanced lives. Our purpose is to advocate for and improve the overall well-being of those we serve, through balanced treatment of the mind and body.

Our members, providers and partners fully entrust us to deliver outstanding quality care through coordinated behavioral health services, employee assistance programs, organizational consulting, student well-being programs and more.

When you join Lucet, you become a valued member of our team, serving more than 15 million people across the U.S. Our employees have a passion for helping others - and it shows. From entry-level employees to senior leaders, we are inspired by our members, putting them first in everything we do. From day one, you'll see firsthand the impact you have on our members, knowing you can make a true difference in their lives.

Job Summary

The Care Manager is responsible for providing case management and support activities for Lucet members who have been discharged from inpatient or residential treatment settings, need assistance during a signification treatment transitions, or have co-occurring medical and behavioral health conditions and who meet the Lucet eligibility criteria for integrated case management. This includes significant coordination with all departments within Lucet, health plans, facilities and providers to promote effective, efficient and quality care for Lucet members..

Essential Functions

• Utilizes the components of the case management process including elements of comprehensive assessment, identification of targeted barriers to improvement, linking to needed professional and community resources, development of care plan, implementation of care plan, documentation of outcomes, iterative care plan review and adjustment based on outcomes, health stabilization, and patient graduation
• Promotes and provides quality service delivery and effective care transitions planning for optimal member health outcomes
• Uses motivational interviewing to engage and maintain relationships with members
• Conducts telephonic assessments with the members to gather information regarding the member's current treatment, possible treatment needs and identify any barriers to accessing services
• Conducts face to face and/or telephonic communication with the member and/or member's parents/guardian, facility, and outpatient providers, including primary care physician (PCP) to gather information to identify discharge needs and any barriers to accessing post hospital discharge services and facilitate coordination of services
• Develops goals and objectives with the member to promote self-management, avoid readmission and connect the member with timely aftercare services
• Collaborates with member and facilitates coordination and communication between member and their providers and support system to create crisis prevention plan
• Assists the member to engage successfully with their behavioral providers and others in their support system to move toward self-management
• Facilitates coordination, communication and collaboration on behalf of the member to achieve goals
• Builds trusting collaborative relationships
• Demonstrates case management expertise in response to a variety of circumstances ranging from crisis intervention to routine business matters
• Coordinates with Health Plan medical management and medical services providers, including primary care physicians and patient centered medical homes, to promote integrated member health care
• Participates in clinical staffing and other meetings and trainings upon management request
• Presents clinical cases to staff and consulting providers upon request of supervisor and as required by case management, policies, and procedures
• Utilizes appropriate tools such as Lucet approved case management models, assessment instruments, practice guidelines, and other applications and tools
• Completes appropriate documentation in clinical systems in compliance with regulatory and accreditation standards
• Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and Lucet services, policies and procedures and criteria
• Coordinates consultations with member's provider, family and Lucet Physician consultants on clinical cases when necessary and appropriate to facilitate care and progress
• Stays current with case management technology, member BH benefits, and non-health community resources
• Provides follow-up and support calls to members and providers as needed and as assigned by Manager/Supervisor
• Makes recommendations of programs and/or systems that create improved outcomes and timeliness of the case management department
• Contributes to site specific audits/surveys/research projects that are relevant to case management process, policies, and procedures
• Participates in on-going continuing education as required by professional licensure, certification, or as requested by Lucet and maintains clinical licensure and certifications
• Participates in special committees or projects for program development as assigned by Manager/Supervisor
• Adheres to the policies and procedures for case management activities as well as screening, triage and referral activities, including timeliness of activities/services and accuracy of documentation
• Adheres to Lucet Mission Statement, Core Values, Code of Business Conduct, and Compliance Program
• Complies with all Federal and applicable State laws and Lucet Policies regarding, privacy, confidentiality, and security of health information, and other designated information

Job Qualifications

Required

• Has a current, unrestricted state license issued by a state or territory of the United States to practice independently as a Clinical Social Worker, Marriage and Family Therapist, Professional Counselor, Clinical Psychologist or Registered Nurse in the state in which the business operation is located and/or other states as required by law, regulation or contract.
• Minimum of 2 years of direct clinical care experience
• Excellent verbal and written communication and interpersonal skills
• Strong computer and keyboarding skills (Microsoft Outlook and Word), including the ability to document while simultaneously while taking information over the phone
• Ability to comprehend medical policy and criteria to clearly articulate health information

Preferred

• Certified Case Managers (CCM) are preferred with requirement to obtain CCM within the first year of hire

Key Competencies

• Self-motivated and the ability to assume a role in ensuring that all objectives are met
• Ability to work independently to meet case load requirements and team objectives/goals
• Proven interest in professional development through specialization, certification, and/or advanced degree
• Maintains curiosity and an eagerness to explore new knowledge and try new ideas and approaches to case management
• Professional demeanor in response to all situations regardless of the nature or circumstances of the situation
• Able to manage multiple tasks in a fast-paced, changing environment
• Ability to work within a collaborative, team-oriented environment

Working Conditions

• Physical
  • Constant:
    • must be able to remain in a stationary position
    • must be able to move about inside the office
    • must be able to communicate and exchange information with others
    • must be able to inspect information
    • must be able to perform repetitive motion with arms and fingers
  • Mental
    • Constant
      • must be able to interpret data
      • must be able to problem solve
      • must be able to make decisions
      • must be able to organize and plan
    • Work is performed indoors in a typical office environment- not substantially exposed to adverse environmental conditions
    • Frequent exposure to VDT screen
    • Frequent use of office machines to include telephone, copier, computer and fax machine