Care manager

Company Name:
ValueOptions is a health improvement company that serves more than 32 million individuals. On behalf of employers, health plans and government agencies, we manage innovative programs and solutions that directly address the challenges our health care system faces today. A national leader in the fields of mental and emotional wellbeing, recovery and resilience, employee assistance, and wellness, ValueOptions helps people make the difficult life changes needed to be healthier and more productive. With offices nationwide and a network of more than 130,000 provider locations, ValueOptions helps people take important steps in the right direction. We help them live their lives to the fullest potential.
At ValueOptions, it's more than a job. Our employees embrace the company vision of helping people lead healthier lives. The over 3,100 employees on our team enjoy challenging career growth in an environment that values integrity, innovation, consumer engagement and joint accountability. Employees have access to comprehensive benefit packages; corporate discounts; continuing education opportunities, including our online learning portal, and more. At ValueOptions we strive to build a boundless culture and community of professionals that includes honest, open and free-flowing communication. We are passionate about the work we do.
If you have a passion to make a difference and a thirst to actively develop your knowledge and skills, join the ValueOptions team!
We are currently seeking a dynamic Clinical Care Manager (Methadone Case reviews) to join our team at our office in Rocky Hill CT. The Clinical Care Manager performs an integral role by facilitating high quality, cost effective managed behavioral health care for members. The Clinical Care Manager functions as part of an interdisciplinary team designed to meet the needs of the Partnership's population.
_Position Responsibilities:_
_Address member and provider issues telephonically. The majority of the Clinical Care Managers work is done telephonically._
_Based on information submitted by the transportation ASO, review authorization requests in which a member would travel greater than 15 miles one way to receive Methadone Maintenance services. _
_Perform outreach calls to the requesting provider, the member, and/or potential alternate provider(s) to assess the necessity for such long-distance transportation, and whether the Methadone service could be provided closer to the member's residence._
_Incorporate into the review any factors that might contribute to the choice of provider, including the member's medical conditions and location of additional service providers, if necessary. _
_Review the member's presenting information and the service location to determine if alternate means of transportation are available. _
_Make a recommendation to the transportation ASO about whether to authorize the transportation or not, based on the outcome of the assessment, including alternatives to the original request, as appropriate. _
_Collaborate with VO clinical staff to match members seeking Methadone Maintenance services to providers located as close as possible to the member's residence._
_Research and refer to appropriate community resources to address needs impacting member's health, safety or ability to access care that cannot be met through contracted benefits._
_Develop collaborative relationships with providers to deliver appropriate and timely healthcare services. Establish relationships with identified members, family and social support systems, when indicated._
_Help develop and facilitate implementation of the most cost effective plan of care for identified members while helping to ensure that members receive high quality care. _
_Advocate for member's needs to facilitate movement through systems, both internal and external to the organization. _
_Initiate and/or participate in patient care conferences with other health care professionals._
_Provide care management services in a caring, professional and responsive manner._
_Provide EPSDT care management when needed by facilitating referrals, developing and coordinating a plan of service._
_Participate in quality management activities through documentation, reports, Interrater Reliability testing and audits._
_Position Requirements:_
Education _: This position requires a Master's Degree and independent licensure in one or more of the following: Social Work-LCSW, Licensed Professional Counselor-LPC, Marriage and Family Therapist-LMFT, Licensed Alcohol and Drug Counselor -LADC or Registered Nurse-RN _
Licensures: Connecticut license
Relevant Work Experience: _Two years post master's degree experience in the delivery of social work/counseling services in a behavioral health care or home health setting is required. Knowledge of local community resources is essential. Working knowledge of care management principles and practices, cost containment principles, excellent PC skills, analytical and problem solving skills needed. Managed care experience is a benefit._
Knowledge, Skills & Abilities :
_Computer skills Required_
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ValueOptions is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.
Position Location: CT - Rocky Hill
FTE Status: Full time
Scheduled Weekly Work Hrs: 40
Job Family: Clinical, Licensed
ID: 32267

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