Behavioral Health Case Manager

Umpqua Health is a Coordinated Care Organization (CCO) in Roseburg, Oregon that connects over 30,000 Douglas County OHP members to physical, dental, and behavioral health services and benefits through an integrated network of providers.
Umpqua Health is currently seeking a Behavioral Health Case Manager to join our team.
Full-time position.
Generous benefit package including; PTO, Health/Vision/Dental Insurance, 401k with a company match, gym membership reimbursement and more.
Salary is dependent upon experience.
The Behavioral Health Case Manager (CM) is responsible for coordinating the care of Oregon Health Plan (OHP) members enrolled with Umpqua Health Alliance.
Case Managers are responsible for developing and implementing member-centric, individualized care plans and providing telephonic and community-based care coordination for members with high health care needs, including members with complex behavioral concerns, severe and persistent mental illness, substance use disorders, and/or receiving facility based, in-home or community-based psychiatric services.
Behavioral Health Case Managers possess clinical expertise in behavioral health conditions and experience navigating the continuum of behavioral health care delivery to provide coordination that is member focused, strengths based, trauma-informed, and culturally and linguistically appropriate.
ESSENTIAL JOB RESPONSIBILITIES Care Coordination and Care Planning Engage members in locations most comfortable to them when discussing care coordination (i.
e.
: in-home visit, synchronized video, community-based location).
Provide care coordination support and coaching to members, which may include developing motivational strategies to promote their progression through the stages of change in alignment with evidence-based medicine and best practices.
Utilize a trauma-informed approach to provide member-centric care and support.
Meet with members and their families to assess needs and identify risk factors including physical condition, behavioral issues, mental status, social support system availability, and relationship with providers.
Utilize assessment information to develop an individualized care plan to address member identified needs, minimize health risk(s), and improve health outcomes.
Identify risk factors and barriers to goals, including periodic reassessment of service needs.
Advocate and assist members in navigating the health care system and accessing community resources.
Connect members with professional services and maintain consistent communication, assessing their progress toward care plan goals, and making changes to the treatment plans as needed.
Track and monitor referrals, detail purpose and outcomes from home visits, and record all other relevant interactions with members.
Maintain accurate and current documentation for members that captures all case management engagement activities to effectively coordinate care.
Transition Planning Facilitate member transitions through the continuum of care, ensuring member placements are grounded in best practices and medical necessity.
Assist in transition/discharge planning for members discharging from acute care settings or those who are transitioning from long term care, the Oregon State Hospital or other residential facilities to ensure a smooth transition back to community-based supports.
Ensure discharge/transition plans are evaluated holistically from physical and behavioral health perspectives.
Ensure members on the state hospital Ready to Transition (RTT) list are prioritized for referral into appropriate transition setting through collaboration with and community partners.
Coordinate care for members receiving care or transitioning outside of service area as required.
Interdisciplinary Care Team and Community Engagement Provide community outreach and/or education on UHA’s Behavioral Health Care Coordination program.
Work effectively and diplomatically within multidisciplinary care teams and actively participate in Interdisciplinary Team (IDT) Meetings, which include internal and external participants.
Work closely and collaborate with behavioral health treatment providers, crisis services, Developmental Disability, APD, DHS, etc.
Maintain consistent and reliable communication with members and community partners to promote member success in improving health outcomes through collaborative integrated care planning.
Coordinate emergency assistance for members by communicating with members and vendors, collecting, and completing necessary paperwork and vouchers, and submitting requests for Flexible Spending to utilization management.
Compliance and Reporting Demonstrate current and on-going knowledge of benefits for Medicare and Medicaid populations.
Maintain updated knowledge of the Oregon Administrative Rules (OAR) governing OHP and Care Coordination.
Follow Medicare guidelines, the appeals and grievance process, and the members’ rights and responsibilities as stated by the Division of Medical Assistance Program (DMAP aka HSD) Oregon Health Authority (OHA) and Centers for Medicare and Medicaid Services (CMS).
Educate members on their rights and responsibilities, including consent required for release of protected health information necessary to coordinate requested care.
Comply with organization’s internal policies and procedures, Code of Conduct, Compliance Plan, along with applicable Federal, State, and local regulations.
Use judgment and discretion in dealing with confidential matters.
QUALIFICATIONS Bachelor’s degree in behavioral science, social science or related field or a license in a field that qualifies you to take the Certified Case Management (CCM) exam (for example: RN, LCSW, LPC, CRC, CDMS, MA eligible for CCM certification).
Must be eligible for Case Manager certification (CCM) or a Certified Community Health worker (CHW) within one year of employment.
Excellent interpersonal, written, and oral communication skills.
Ability to meet department standards for competency in the use of motivational interviewing within 12 months of hire.
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 50 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
No suspension/exclusion/debarment from participation in federal health care programs (e.
g.
Medicare/Medicaid).
UH is an equal opportunity employer that is committed to diversity and inclusion in the workplace.
We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.
This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship.
UH makes hiring decisions based solely on qualifications, merit, and business needs at the time.
For more information, read through our EEO Policy.
Drug-free Workplace: Umpqua Health is committed to providing a drug-free workplace for its employees and the communities it serves.
This position requires successful completion of pre-employment screening which includes, but is not limited to; drug screen, criminal and federal background check, and other licensure requirement verifications.
For more information or to apply visit our website at www.
umpquahealthcareers.
com