The Clinical Case Manager supports 50+ sub-contracting providers in providing behavioral health and therapy services through Kaiser Permanente. The Clinical Case manager liaises between the clients, departments and resources to assess and coordinate client treatment and therapy plans, and is responsible to oversee the administration of coordinated care to ensure that each client receives high quality services. The Case Manager would review all reports prior to submission to ensure that required information is appropriately documented.
ESSENTIAL JOB FUNCTIONS
Conduct clinical and psycho-social assessments.
Responsible for the development of a comprehensive and clinically appropriate care plan in collaboration with the interdisciplinary team.
Follows care plan through effective health coaching and risk management
Responsible for assessing and addressing risk, and escalates high risk clinical concerns to supervisor
Serves as a liaison between client and other departments
Responsible for the final review, approval and submission of all clinical reports to the funder
Works with providers to make appropriate revisions needed on clinical reports
Serves as the main contact for clients and families and responds to all client inquiries ; responsible to ensure client’s needs are met
Makes decisions regarding authorization extension requests for clients
Responsible for providing resolution to client concerns, including provider change requests as appropriate.
Completes documentation regarding all interactions with the client, provider and interdisciplinary team, using appropriate systems and procedures in a timely manner, per agency policies.
Assigns clients to appropriate ABA and/or Therapy Providers for services
Responds to all funder inquires involving their client
Collaborates with the provider regarding clinical concerns related to their client
Documents all client complaints and grievances, and submits these to the ESBA Quality department, per policy requirements
Submits all client related Reportable Event forms from providers to the ESBA Quality department.
Attends staff meetings, in-services, trainings, and other meetings as requested by management
Participate in special projects, and assist with additional duties or tasks, as assigned by supervisor
Must adhere to all federal, state and local laws/legislations as applicable as well as HIPAA laws and regulatory agencies
Attaining and achieving position competencies in relation to role responsibilities
Minimum Education, Experience & Training Equivalent to:
Master's degree from an accredited college or university in social work is required
LCSW or LMFT Required
One to two years of related professional experience working with children with autism spectrum disorders (“ASD”) and/or other related developmental disabilities in a multi-disciplinary team setting preferred
Previous experience of case management or clinical experience, and responsibility for a large caseload for an extended period of time.
Knowledge of community resources and experience networking
Demonstrated expertise in crisis management.
Knowledge, Skills & Abilities:
Familiar with the field of early intervention, ABA, and knowledgeable of other community resources and agencies that serve children.
Able to conduct strengths based, client centered psychosocial assessments and refer clients for clinically appropriate services
Able to consistently demonstrate good judgment and decision-making skills.
Able to appropriately interpret and implement policies, procedures, and regulations.
Excellent coalition building skills with the ability to communicate and work effectively with a variety of internal and external stakeholders.
Able to work with sensitive information and maintain confidentiality and have a high level of professionalism.
Excellent client-facing and internal communication skills.
Strong organizational skills including attention to detail and ability to multi-task.
Ability to work in an exciting, fast paced high energy environment while effectively multitasking. Sensitive to working with an ethnically, linguistically, culturally, and economically diverse population.
Able to travel to multiple work sites if needed. Reliable transportation needed.
Excellent computer, analytical and research skills, including ability to learn unfamiliar programs quickly
A commitment to the values of the organization while demonstrating good judgment, flexibility, patience and discretion when dealing with confidential and sensitive matters.
Easterseals Bay Area/theBHPN is an equal opportunity employer
Internal Number: 1719
About Easterseals Bay Area/theBHPN
The BHPN (the Behavioral Health Provider Network) is one of the largest behavioral health networks specialized in autism in the U.S. The providers in the network serve children and adults living in Northern California with behavioral health service needs, including applied behavior analysis (ABA), occupational therapy, speech therapy, and physical therapy. Headquartered in Walnut Creek, the BHPN team works collaboratively with its behavioral health and therapy providers to ensure clients and families receive timely access to quality treatment.
You would be a great fit at the BHPN if you are interested in joining a team committed to changing the way the world defines and views disability by making profound, positive differences in people’s lives every day. The BHPN is experiencing rapid growth and offers a dynamic employment environment with exceptional opportunity for personal growth.
The talented and dedicated BHPN team specializes in business and support areas, including Case Management, Clinical Support, Quality, Compliance, Finance and Information Technology. The BHPN is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF) Internati...onal. This three-year accreditation certifies that the BHPN meets internationally recognized standards for high-quality services and is the highest level recognition that CARF awards. The CARF surveyors noted that “the organization demonstrates a strong commitment to the clients [which is] clearly visible in the staff members’ conscientious attention to detail and collaborative efforts."
Founded in 2012 in Northern California, today the BHPN has over 100 behavioral health and therapy providers in the network and a client base of more than 8000 clients, which continues to grow.