Your Role
Reporting to the Manager, Care Management- Behavioral Health, the Licensed Clinician, Senior (ABA Case Manager) helps members with behavioral health needs navigate the health care system for linkages to behavioral health providers, treatment, and programs. This role is ideal for professionals with a background and experience in Applied Behavioral Analysis and passion for ensuring access to high quality behavioral health services. The ABA Case Manager will coordinate care and services for families, supporting members and families through their care. The ABA Case Manager will offer support in assessing members’ emotional and psychological well-being and providing resource coordination, crisis intervention, and with any general behavioral or mental health referrals. The position requires an intensive focus on crisis intervention and counseling, problem-solving and conflict resolution, patient and family management, interdisciplinary collaboration, psychosocial assessments, education, advocacy, and community resource linkages.
Your Work
In this role, you will:
- Collaborate with other Case Managers and Utilization Management to complete member assessments related to social and resource needs to support member access to services
- Collaborate with service coordination staff and act as liaison to ensure a timely and accurate response to member needs
- Collaborate with providers to support members’ treatment plan and care needs
- Recognize the client’s right to self-determination as it relates to the ethical principle of autonomy, including the client/family's right to make informed choices that may not promote the best outcomes, as determined by the healthcare team
- Assess members health behaviors, cultural influences and clients belief/value system and evaluates all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriers
- Efficiently manages and maintains a caseload of members for behavioral health care coordination and or BH case management for persons experiencing severe and persistent mental illness as well as members seeking and utilizing ABA services.
- Maintains an active workload in accordance with National Care Manager performance standards.
- Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.
- Interacts with Utilization department and Physician Advisors to discuss clinical questions and concerns regarding specific cases.
- Coordinates services with state and community programs on behalf of the member, particularly when the member is unable to effectively do so independently
- As a mandated reporter, files and follows-up on reports made to the appropriate government agency (e.g., Adult Protective Services, Child Protective Services, etc.)
- Actively participates in Interdisciplinary Team Meetings and case consultations with Licensed Manager.)
Your Knowledge and Experience
- Current unrestricted CA License (LCSW, LMFT, LPCC, Registered Nurse (RN), or PsyD by the Board of Behavioral Health Sciences required
- Requires at least 5 years of prior relevant experience including 3 years of experience in behavioral health or ABA, case management.
- Advanced degree commensurate with field is preferred
- BCBA Preferred
- Experience conducting thorough psychosocial assessments, developing care plans and providing necessary interventions identified during assessment with complex client populations that may have, among other things, inadequate coping skills, severe emotional disorders, developmental disabilities, mental illnesses, and/or unstable housing
- Considerable knowledge of a wide range of psychosocial challenges and familiarity with behavioral health diagnoses and treatment
- Previous health plan or insurance experience preferred.
- Proficient with computer programs such as Microsoft Excel, Outlook, Word, and PowerPoint
