• Health Plan Associate Behavioral Health Case Manager

    Job Number
    222786
    Facility
    Univ Physicians Health Plans
    Department
    HP Statewide Behav Health
    Address : Street
    2701 East Elvira Rd
    Address : Location
    US-AZ-Tucson
    Work Schedule
    Day
    Position Type
    FT: Full-Time
    Posting Category
    Behavioral Health Services
  • ---

    Health care is changing, and it’s our goal to create a new model to answer America's health care challenges today and in the future. Our passionate and talented teams will be the change on the health care landscape in our communities – big and small. If taking access and delivery from complex to easy, from costly to affordable and from unpredictable to reliable sounds interesting to you, we want to hear from you.

     

    As a Health Plan Associate Behavior you will conduct care management with members for the behavioral health department. Participating in meetings within the department and with providers; heavy documentation of medical records, advocacy and engaging members in their own treatment.

     

    Must have experience in the public behavioral health system. 

    After training, 100% remote
    Mon-Fri 8-5pm
    Accepting applicants in both of our office locations located in Mesa and Tucson:  

     

    Mesa Corp.

    525 W Brown RD

    Mesa, AZ 85201

     

    UAHP

    2701 E Elvira

    Tucson, AZ 85756 

    ---

    About University Physicians Health Plans
    The University of Arizona Health Plans (UAHP) manage a variety of health plans. Our mission is to advance health and wellness through education, research and patient care.

     

    Truven-2013
    Stage7-2013

    About Banner Health
    Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.

    ---

    Job Summary

    This position provides comprehensive care coordination for members/patients as assigned. This position assesses the members/patients plan of care needs, and develops, implements, monitors and documents the utilization of resources and progress of the member/patient through their care episodes, facilitating options and services to meet the members/patients health care needs. The intensity of care coordination provided is situational and appropriate based on member/patient need and payer requirements. This position is accountable for the quality of case management services delivered by both them and others and identifies/resolves barriers which may hinder effective member/patient care.

     

    Essential Functions

    • Manages individual members/patients across the health care continuum to achieve the optimal clinical, financial, operational, and satisfaction outcomes.

     

    • Acts in a leadership function with process improvement activities for populations of patients/members to achieve the optimal clinical, financial, operational, and satisfaction outcomes.

     

    • Evaluates the medical necessity and appropriateness of care, optimizing member/patient outcomes.

     

    • Establishes and promotes a collaborative relationship with physicians, payers, and other members of the health care team. Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements.

     

    • Acts in a leadership function to collaboratively develop and manage the High Need/High Cost Program and manage the interdisciplinary member/patient case staffing to ensure high levels of care coordination to promote improved health care outcomes or discharge plan. Effectively communicates the plan across the continuum of care.

     

    • Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts into daily practice.

     

     

    Minimum Qualifications

    Requires bachelors degree in social work or related field or equivalent experience.

    Requires a proficiency level typically achieved with 5 years of clinical/case management experience and knowledge of Medicare and Medicaid Programs. Must have a working knowledge of care management, hospital and community resources. Must demonstrate critical thinking skills, problem-solving abilities, effective communication skills, and time management skills. Must demonstrate ability to work effectively in an interdisciplinary team format.

    Preferred Qualifications

    Bi-lingual preferred.

    Additional related education and/or experience preferred.

    Connect With Us!

    Join one of our Talent Communities to learn more about a career at Banner Health.