Health Plans Associate Behavioral Health Case Manager Arizona

Primary City/State:

Arizona, Arizona

Department Name:

Behavioral Health

Work Shift:

Day

Job Category:

Clinical Care

You have a place in the health care industry. If you’re looking to leverage your abilities to make a real difference – and real change in the health care industry – you belong at Banner Plans & Networks.

Banner Plans & Networks (BPN) is an integrated network for Medicare and private health plans. Known nationally as an innovative leader, BPN insurance plans and physicians work collaboratively to keep members in optimal health while reducing costs. Supporting our members and vast network of providers is a team of professionals known for innovation, collaboration, and teamwork. If you would like to contribute to this leading-edge work, we invite you to bring your experience and skills to BPN.

As a Health Plans Associate Behavioral Health Case Manager, you will work as part of an interdisciplinary team. You will work daily in a team environment and call upon your Case Manager work history to help members access care in the community. Your interactions with members will primarily be by phone.

Your work location will be entirely remote. Due to contractual requirements, you must reside in the State of Arizona for this position. Your work shifts will be Monday-Friday working in the Arizona time zone business hours. If this role sounds like the one for you, apply today!

Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY
This position provides comprehensive care coordination for members as assigned. This position assesses member’s needs to identify possible gaps in care. This position assists in facilitating provider engagement to address services to meet the member’s needs. The intensity of care coordination provided is situational and appropriate based on patient need and payer requirements. This position is accountable for the quality of clinical services delivered by both them and others and identifies/resolves barriers which may hinder effective member care.

CORE FUNCTIONS
1. Manages individual members/patients across the health care continuum to achieve the optimal clinical, financial, operational and satisfaction outcomes.

2. Acts in a leadership function with process improvement activities for populations of patients/members to achieve the optimal clinical, financial, operational, and satisfaction outcomes.

3. Evaluates the appropriateness of care, optimizing patient outcomes.

4. Establishes and promotes a collaborative relationship with providers, other payers, and other members of the health care team. Collects and communicates pertinent, timely information to fulfill utilization and regulatory requirements.

5. Acts in a leadership function to collaboratively develop and manage the interdisciplinary member discharge plan. Effectively communicates the plan across the continuum of care.

6. Educates internal members of the health care team on care management and managed care concepts. Facilitates integration of concepts into daily practice.

7. Has freedom to determine how to best accomplish functions within established procedures. Confers with supervisor on any unusual situations. Positions are facility based with no budgetary responsibility. Internal customers: All levels of health plan staff and members of the interdisciplinary health care team. External Customers: Physicians and their office staff, other payers, community agencies, provider networks, and regulatory agencies.

MINIMUM QUALIFICATIONS

Requires bachelor’s degree in social work or related field or equivalent experience.

Requires a proficiency level typically achieved with five years of experience. Must have a working knowledge of care management, hospital and community resources. Must demonstrate critical thinking skills, problem-solving abilities, effective communication skills, and time management skills. Must demonstrate ability to work effectively in an interdisciplinary team format.

PREFERRED QUALIFICATIONS

Additional related education and/or experience preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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