Clinical Case Manager BH

Duration : 03 months(Possible FTE)

Responsibility :

• The Care Plan Reviewer (Clinical Case Manager BH) utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination / collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Be clinically and culturally competent / responsive with training and experience necessary to manage complex cases in the community across child-serving systems.
• Assessment of Members
• Through the use of clinical tools and information / data review, conducts comprehensive assessments of referred member's needs / eligibility and determines approach to case resolution and / or meeting needs by evaluating member's benefit plan and available internal and external programs / services. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues.
• Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated. Provides crisis follow up to members to help ensure they are receiving the appropriate treatment / services. Enhancement of Medical Appropriateness and Quality of Care :
• Application and / or interpretation criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and / or member's needs to ensure appropriate administration of benefits. Using holistic approach consults with supervisors, Medical Directors and / or other programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary view in order to achieve optimal outcomes.

Required Qualifications :

About US Tech Solutions :

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit .

US Tech Solutions 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 status as a protected veteran.

Recruiter Details : Name : Shivani

Email : shivani.sharma@ustechsolutionsinc.com

Internal Id : 24-27285