Behavioral Health Care Management Specialist I at Health Plan of San Mateo

, California, United States -

Full Time

Start Date

Immediate

Expiry Date

02 Jan, 26

Salary

0.0

Posted On

05 Oct, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Care Management, Behavioral Health, Provider Matching, Communication, Team Collaboration, Problem Solving, Spanish Bilingual, Healthcare Documentation, Assessment, Medi-Cal, Medicare, Data Entry, Microsoft Office Suite, Community Resources, Adaptability, Record Keeping

Industry

Hospitals and Health Care

Description

General Description Serves as a member liaison, responsible for intaking and facilitating care coordination for HPSM members with Behavioral health treatment needs. The primary focus is responding to requests for behavioral health provider matching and guiding members that are receiving behavioral health care and linking members to appropriate providers. Spanish bilingual skills required. Qualifications The following represents the typical way to achieve the necessary skills, knowledge and ability to qualify for this position: Education and Experience Bachelor’s degree in the field of health, business or public administration. Bachelor’s degree in mental health or social services or 1 year of relevant work experience in a Behavioral health setting. Two (2) or more years of experience in health care, preferably in a Behavioral health field (such as mental health, youth Autism services, or substance use treatment). Experience working with the health needs of the population served. Knowledge Care management, Medi-Cal, and Medicare benefits as well as the complexities of working with the elderly and disabled population. Assessment and diagnoses approaches. Types of Behavioral Therapy and services. Healthcare documentation protocols. Bilingual skills particularly Spanish. Personal computers with proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint. San Mateo County community resources. Abilities Work cooperatively with others. Work as part of a team and support team decisions. Communicate effectively, both verbally and in writing, with members and colleagues. Adapt to changes in requirements/priorities for daily and specialized tasks. Licensure/Certifications Not Applicable. Driving Not Applicable. DUTIES & RESPONSIBILITIES Essential Functions Care Coordination and Member Support Function as part of a multidisciplinary care team to manage plan members utilizing a behavioral health focus. Responsible for assessing, responding to, and following through on requests for Behavioral Health provider matching, including answering live member calls on the Behavioral Health matching line, assessing requests, identifying appropriate provider(s), facilitating coordination and conducting follow up with members. Support HPSM members with questions and navigation of behavioral health services and benefits; this may include Non-specialty, Specialty, and Alcohol and Other Drug (AOD) services provided by San Mateo County’s Behavioral Health and Recovery Services (BHRS), as well as Behavioral Health Treatment (BHT). Work with healthcare providers to support referral and provider matching management. Maintain accurate records of audit activities and ensure all related deadlines are met. Process Improvement and Problem Solving Prepare post-audit reports and clearly communicate findings to internal and external stakeholders. Identify and mitigate barriers to appointment adherence both on an individual member basis and by identifying process improvement opportunities. Contribute to departmental problem solving and process improvement on an ongoing basis. Actively contribute to team problem solving and operations through group meetings and other types of collaboration. Collaboration and Administrative Responsibilities Collaborate across departments to share information, support members, and maintain strong relationships with behavioral health providers. Maintain regular contact with key partners. Perform administrative tasks generating provider match letters, researching and tracking provider availability, conducting data entry, and producing reports. Secondary Functions Adhere to work performance norms and attendance expectations. Perform other duties as assigned.

Responsibilities

The Behavioral Health Care Management Specialist I is responsible for intaking and facilitating care coordination for HPSM members with behavioral health treatment needs. This includes responding to requests for provider matching and guiding members to appropriate behavioral health services.