Care Management Associate - Must live in Louisiana

at  CVS Health

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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

POSITION SUMMARY

The Aetna Better of Health Louisiana on the Behavioral Health Crisis Call Center is a critical component of the Louisiana Department of Health overhaul of the state’s Crisis System. This role serves as the initial contact for Aetna Better Health of Louisiana member Behavioral Health crisis calls.

REQUIRED QUALIFICATIONS

• Must reside in Louisiana
• 2-4 years Healthcare experience (i.e., medical setting, hospital, managed care organization).
• 1-2 years Behavioral Health experience
• 1-2 years Call Center experience
• 1-2 years Customer Service experience
• 1-2 years Sensitive information and/or HIPAA experience
• Computer skills, including Microsoft Office suite
• Basic Medical Terminology
• Strong Organizational skills
• Verbal and Written Communication skills
• Ability to multitask, prioritize work, maintain flexibility, and manage expectations while meeting scheduled deadlines.
• Flexibility to work occasional nights and weekends outside of standard business hours which can span from 8:00 am to 5:00 pm.

PREFERRED QUALIFICATIONS

• High Call Volume experience
• Crisis intervention skills and call center experience in handling life stress, substance misuse, depression/anxiety, symptoms of psychosis, thoughts/risk of self-harm/suicide, thoughts/risk of harm to others, change in youth’s living situation, disruptive behavior, and family conflict.
• Demonstrates ability to meet daily metrics with speed, accuracy, and a positive attitude.
• Adhering to Care Management Processes (privacy/confidentiality, quality management, regulatory, accreditation guidelines, company policies and procedures).
• Member Electronic Record experience
• Works independently
• Ability to effectively participate in a multi-disciplinary team including internal and external participants.

EDUCATION

• High School Diploma, G.E.D. or equivalent. (Required)
• Bachelors Degree in Human Services or related field (Preferred)

• Answer initial member Behavioral Health Crisis Calls, triage/assess risk, and transfer to Licensed Mental Health Clinicians.
• Answer calls to a secondary phone line from community Mobile Crisis Teams and record member updates and disposition as needed.
• Appropriately and accurately document state mandated Crisis Call metric
• Focus on prioritizing Medicaid member interaction, maximizing inbound and outbound touchpoints to solve members’ needs and create behavioral change by being passionate, caring and use behavioral interviewing techniques.
• Work closely with Licensed Mental Health Clinicians and Care Management Associates.
  Care Management Associates provide support services to team members by answering telephone calls, taking messages, researching information, warm transferring of member calls to appropriate internal clinical colleagues, and assisting in solving problems. The Care Management Associate adheres to Compliance with policies & procedure/regulatory standards, maintains accurate & complete documentation of required information that meets risk management, regulatory, & accreditation requirements, and protects the confidentiality of member information & adheres to company policies regarding confidentiality.