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US Family Health Plan- A TRICARE Prime option | Behavioral Health Care Manager

US Family Health Plan- A TRICARE Prime option
New York, NY Full Time
POSTED ON 1/20/2025
AVAILABLE BEFORE 4/20/2025

JOB SUMMARY

The Behavioral Health Care Manager is a core member of the collaborative care team, including the beneficiaries’ medical and psychiatric providers. The behavioral health care manager is responsible for supporting and coordinating the mental and physical health care of beneficiaries on an assigned caseload with the beneficiaries’ medical and, mental.

health providers. The behavioral health care manager will also act as the liaison between the behavioral health partner. Magellan, and USFHP team to assist beneficiary, care giver and providers to navigate the continuum.

RESPONSIBILITIES

  • Support the mental and physical health care of beneficiaries on an assigned beneficiary caseload.
  • Closely coordinate care with the beneficiaries medical and behavioral health providers.
  • Monitor and identify ongoing and / or newly identified :
  • Unresolved psychosocial barriers to care
  • Linkages to community resources based on SDOH needs
  • Behavioral health concern
  • Unstable or worsening mood
  • Conduct initial assessments of beneficiaries’ social, psychosocial and environmental situations, to determine needs, goals and referral to behavioral health care management programs.
  • Screen and assess beneficiaries for common mental health and substance abuse disorders.
  • Facilitate beneficiary engagement and follow-up care.
  • Provide beneficiary education about common mental health and substance abuse disorders and the
  • available treatment options.
  • Directs beneficiary and or caregivers to appropriate community agencies and resources as need dictates
  • Identifies and assists with managing obstacles to treatment and or discharge plans
  • Systematically track treatment response and monitor beneficiaries by telephone for changes in clinical symptoms and treatment side effects or complications.
  • Support psychotropic medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment.
  • Provide brief behavioral interventions using evidence-based techniques such as behavioral activation, problem-solving treatment, motivational interviewing, or other treatments as appropriate.
  • Provide or facilitate referrals to evidence-based psychosocial treatments (e.g. problem-solving treatment or behavioral activation) as clinically indicated.
  • Participate in regularly scheduled caseload rounds with Magellan and Medical CM teams to communicate resulting treatment recommendations to the beneficiary’s medical provider. Focus on beneficiaries new to the caseload and those who are not improving as expected under the current treatment plan.
  • Track beneficiary follow up and clinical outcomes.
  • Document beneficiary progress and treatment recommendations in Electronic Health Record (EHR) and other required systems so as to be shared with medical providers, psychiatric consultant, and other treating providers.
  • Facilitate treatment plan changes for beneficiaries who are not improving as expected in consultation with treatment providers and who may need more intensive or more specialized mental health care.
  • Adhere to and comply with Tricare policies and guidelines.

EXPERIENCE

  • At least 5 years’ experience working with beneficiaries with psychiatric illnesses, including substance use disorders and other behavioral health issues.
  • Experience working with Autistic children and knowledge of Tricare Autism care demonstration (ACD).
  • Inpatient Psychiatry and / or Medical settings preferred.
  • Skills / Competencies

  • Time management and organizational skills
  • Demonstrated ability to collaborate and communicate effectively in a team setting.
  • Ability to convey compassion and emotional skills to build strong beneficiary relationships to assist management of stressful situations and challenges .
  • Use of interpersonal skills to communicate and cultivate productive relationships
  • Ability to maintain effective and professional relationships with beneficiary and other members of the care team.
  • Experience with screening for common mental health and / or substance abuse disorders.
  • Working knowledge of differential diagnosis of common mental health and / or substance abuse disorders, when appropriate.
  • Ability to work with beneficiaries by telephone.
  • Experience with assessment and treatment planning for common mental health and / or
  • substance use disorders.
  • Working knowledge of evidence-based psychosocial treatments and brief behavioral interventions for common mental health disorders, when appropriate (e.g., motivational interviewing, problem-solving treatment, behavioral activation).
  • Basic knowledge of psychopharmacology for common mental health disorders that is within appropriate scope of practice for type of provider filling role.
  • Experience with evidence-based counseling techniques.
  • Experience working with high risk populations including screening for suicidality and facilitating appropriate intervention.
  • Education / Certifications / License

  • Master’s Degree required.
  • Current and Unrestricted State Licensed Clinical Social Worker (LCSW).
  • Upon employment must apply and obtain LCSW in service areas of New Jersey, Pennsylvania and Connecticut.
  • SVCMC IS AN EQUAL OPPORTUNITY EMPLOYER - ALL QUALIFIED APPLICANTS WILL RECEIVE CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, GENDER IDENTITY, NATIONAL ORIGIN, DISABILITY OR VETERAN STATUS.

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