Director of Case Management / Behavioral Health Coordinator - Maricopa County, AZ

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To apply clinical and behavioral health knowledge and work in collaboration for all enrollee's identified as needing or receiving behavioral health services to ensure enrollee needs are met in the most cost-effective manner. Provide support across the LTC case management program and ensure the overall LTC Behavioral Health contractual adherence through monitoring, auditing, and training occur. The Director of Case Management/Behavioral Health Coordinator is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating). This includes case management, coordination of care, problem-solving at the member, family, and provider level and medical/behavioral health management consulting. Function may also be responsible for providing health education, coaching, review/approval of service plans and leading projects.

• Excellent Communication skills and ability to interrelate with individuals at various levels and in various functional areas throughout the organization and to develop effective business relationships
• Working collaboratively with providers, as well as with internal plan management and Medical Directors in setting direction and strategic planning to develop, implement and monitor action plans to modify care delivery patterns and reduce expenses
• Monitor the Court Ordered Treatment process to ensure accurate and timeliness occurs with legal and clinical requirements
• Monitor the Child and Family Team (CFT) facilitation of quarterly Clinical Connection meetings for licensed LTC staff, promote collaboration and best practices
• Supervise the LTC Coordinator for the Office of Human Rights, monitoring portal compliance and Case Manager integration of the person providing Special Assistance's integration into care planning
• Oversee transitions from the Regional Behavioral Health Authority (RBHA) into Long Term Care services for members with an SMI designation
• Develops annual goals and objectives to achieve appropriate reductions in medical expenses that correlate with continuous performance and quality of care improvement efforts
• Provide training to new and existing Case Management staff and providers about behavioral health services, programs and processes
• Oversee the High Risk Behavioral Health case management managerial staff and Behavioral Health Professionals
• Serves as a mentor, monitors adherence to state contract requirements and performance measure outcomes
• Serves as the key Behavioral Health Services/Case Management resource and consultant to internal and external customers. Form strategic relationships which will support program growth, expansion and the development of new models/programs
• Lead and support our LTC case management department staff and Health Plan membership. Ensure overall LTC
• Behavioral Health Medicaid contractual adherence through monitoring, auditing, reporting and training
• Creates a team oriented management environment, enhancing the integration between behavioral, clinical and operations sections of medical affairs
• Review program descriptions and consultation with potential providers joining the network. Complete provider visits to review additional contract requirements for placements with integrated behavioral supports
• Review the Behavioral Health Network to reduce out of state placements and/or actively stay involved in any out of state placement for behavioral health services
• Develops clear goals and objectives for performance management and effectively communicates accountability
• Ensures standardized execution of workflow processes, such as authorizations, adherence to documentation requirements and analyzing outcomes of standardized audits for AHCCCS, HSAG, NCQA and HEIDIS purposes
• Responsible for department policies and procedures, training of LTC Case Management staff and external providers, and day-to-day support clinical support, including Behavior Health and substance use consultations
• Act as the Liaison for children in Department of Child Safety (DCS) custody

• Current, unrestricted Licensed Behavioral Health professional in Arizona OR ability to obtain within seven months of employment
• 5+ years serving individuals who are elderly and/or individuals with physical or developmental disabilities and with an SED or SMI designation
• 5+ years of management experience
• Supervisory and training experience
• Basic knowledge of ALTCS/ Medicare / Medicaid regulations
• Working knowledge of Microsoft Word, Excel, and PowerPoint
• Computer efficiency
• Proven solid written / grammar and communication skills, excellent time management skills, the ability to master new skills and ideas, able to adapt to change, and exhibit flexibility
• Proven ability to function independently and responsibly with minimal need for supervision
• Proven flexible and able to meet short timelines
• Demonstrate initiative in achieving individual, team, and organizational goals and objectives
• Located in Maricopa County, Arizona
• Driver's License and access to a reliable transportation

• Long-term care, home health and managed care experience, and care coordination