What are the responsibilities and job description for the Hybrid BH Clinical Care Manager(LCSW, LMHC or LICSW) - Boston position at Commonwealth Care Alliance?
Position Summary:
Commonwealth Care Alliance's (CCA) Clinical Care Manager is a registered nurse or other independently licensed behavioral health clinician responsible for providing intensive monitoring, follow-up and clinical care management to a panel of health plan members with complex medical, behavioral, and social care needs, including Severe and Persistent Mental illness.
As part of the care management dyad, the Clinical Care Manager works directly with assigned CCA members to help them navigate the health care system, gain access to available services, and assist members with finding answers to their questions. The Clinical Care Manager functions as the clinical expert on an interdisciplinary team through close member oversight, routine and post discharge assessments, providing health education, and provider collaboration. Consults, as needed, with other participants of the interdisciplinary care team on members experiencing medical or behavioral health issues. Responsible for supporting the members in achieving their goals for independent living, recovery, and community connections.
This position allows for remote work, when possible, but does require in-person visits to members in their homes and community, as needed.
Supervision Exercised:
No, this position does not have direct reports.
Essential Duties & Responsibilities:
Complex care management
Care plan development, updates and implementation with members
Member education
Provider communication, including collaboration with DMH and DDS (BH)
Routine member engagement
Quality gap closures, including:
RN Clinical Care Manager
BH Clinical Care Manager
Medication Reconciliation
Follow up after Hospitalization (FUH)
Blood Pressure readings
Initiation and Engagement (IET)
Participate in interdisciplinary care team meetings
Performs applicable standardized assessments, including MDS, Comprehensive, Functional, and Crisis and Risk Assessments
Perform home visits with member for routine assessments, routine clinical needs, and post transitions of care follow up that require in person evaluations
Monitor available data for assigned members to inform proactive outreaches as well as reactive clinically appropriate assessments to ensure comprehensive knowledge of members current needs to inform continuous and meaningful updates to the care and service plan.
Resource and expert for members regarding available benefits and resources to meet their needs.
Clinical resource for other members of the interdisciplinary care team
Additional duties as requested by supervisor
Working Conditions:
Standard office conditions
Must be able to travel to member's homes or other community environment
Must be able to come to the local CCA office and/or provider offices for various meetings as needed.
Responsible to provide a strong internet connection when working remotely
Member Facing:
YES: The job has in-person contact (not telephonic/virtual) with CCA members or patients as part of the job duties.
Required Education (must have):
RN Clinical Care Managers must have:
Associate degree in nursing
Active RN license, in good standing, in state of assignment.
BH Clinical Care Managers must have:
Master's degree in social work or mental health counseling
Must have an active LCSW, LMHC or LICSW license in good standing in the state assigned; may require multiple state licenses based on product
Desired Education (nice to have):
Bachelor's or Master's degree in nursing preferred
Other related Healthcare Degree
Certified Care Manager (CCM)
Required Licensing (must have):
- RN Clinical Care Managers must have an Active RN license, in good standing, in state of assignment.
- BH Clinical Care Managers must have: an active LCSW, LMHC or LICSW license in good standing in the state assigned; may require multiple state licenses based on product
MA Health Enrollment (required if licensed in Massachusetts):
Yes, this is required if the incumbent is licensed in Massachusetts.
Required Experience (must have):
Meaningful clinical and care management experience, including 3 years caring for people with complex medical, behavioral and social needs
Desired Experience (nice to have):
Experience working in a health plan, with Medicare Advantage and/or dually eligible population
Experience with a care management platform (Guiding Care a plus)
Experience with Substance Use Disorders
Required Knowledge, Skills & Abilities (must have):
Proven skills, knowledge base, and judgement necessary for independent clinical decision making in alignment with clinical licensure.
Excellent critical thinking, organizational, time management and problem solving skills.
Ability to function independently and effectively as part of an interdisciplinary team
Strong and effective communication skills, both written and verbal
Strong interpersonal and customer relations skills
Strong customer service skills
Ability to work in multiple systems, often simultaneously.
Flexibility to adapt to business needs
Motivated team player
High attention to detail and accuracy
Required Language (must have):
English
Desired Knowledge, Skills, Abilities & Language (nice to have):
Ability to utilize an Electronic Medical Record or other electronic platforms
Ability to use on-line training platforms
Demonstrated ability to utilize virtual care platforms
Proficiency in Microsoft Office Suite
Bilingual preferred
Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
