Clinical Care Manager: Psychiatric Emergency Services (Evenings)
Company: Community Behavioral Health.
Posted on: January 27, 2023
The Clinical Care Manager is responsible for utilization
management by conducting utilization review activities, population
management, cross-system consultation, provider management and
treatment quality monitoring. The Clinical Care Manager must
utilize clinical knowledge of best practices and evidence based
treatments to ensure CBH members receive timely access to quality,
medically necessary behavioral health services. When clinically
indicated, Clinical Care Managers consult with CBH Physician and
Psychologist Advisors to ensure the most effective treatment for
the CBH member is being authorized. Schedule: Monday - Friday ( 4pm
-12:00am) or Tuesday - Friday ( 2pm - 12:00am) Essential
- Be knowledgeable about behavioral health care services, system
partners, service continuum and established medical necessity
criteria and apply that knowledge in all work activities.
- Complete Utilization Management activities including but not
limited to: interagency meetings, social determinants interviews
with members, treatment team meetings, case consultations, care
coordination, provider meetings, reviews, treatment linkage.
- Complete expected number of UM activities per day/shift as
specified under team specified under team specific responsibilities
in established timeframes.
- Authorize treatment when Medical Necessity Criteria is
- Consult with Physician Advisor, Psychologist Advisor and/or
Clinical Leadership as clinically appropriate.
- Generate denial letters based on physician reviews and in
accordance with state regulations as needed.
- Work directly with members, natural supports and providers in
the community during at least 6 days per month.
- Facilitate care coordination with system partners to address
social determinants, barriers to wellness, and other needs of
members, including connection to appropriate community based
- Demonstrate an understanding of Evidence-Based Practices (EBPs)
and connect members to appropriate evidence-based treatment at
admission, during treatment, and at discharge.
- Monitor member's length of treatment and work collaboratively
with providers and other systems to address barriers to member
receiving treatment in a less restrictive environment.
- Collaborate with other CBH departments to ensure quality of
care, promote placement of members in the most appropriate services
and to facilitate consistent longitudinal care management.
- Document provider quality concerns in accordance with CBH
- Conduct provider and/or stakeholder meetings at least
- Use data to inform clinical decision-making.
- Maintain documentation in CBH's electronic system consistent
with agency and industry standards.
- Respond to care coordination correspondence within 24-48 hours
or sooner if necessary.
- Work collaboratively with team members including assisting with
the training of newly hired employees as requested, covering work
when peers are out of the office as assigned and finding coverage
- Attend all meetings as assigned and actively prepare for and
participate in supervision and clinical case consultations.
- Ensure highest quality of customer service when interacting
with members, providers, and other stakeholders.
- Participate in grievance/complaint hearings as assigned.
- Display commitment to member and family driven care and
principles of resiliency and recovery.
- Participate in NIAC preparation and site visits as needed.
- Maintain an accurate daily log of work completed.
- Contribute to projects and other duties as assigned.Team
- Utilize identified resources to determine eligibility and
- Review and share treatment history and pertinent clinical
information about members receiving a crisis evaluation with
provider to help inform recommendations.
- Complete an average of 20-40 UM activities per shift.
- Conduct in person or telephonic precertifications daily to
determine appropriate level of care for members in crisis.
- Track information, such as bed availability to assist with care
coordination as needed.
- Weekend Shift Friday, Saturday & Sunday hours: 8:00 am - 9:00
- Education: Master's degree in Social Work or related field or
- License/Certification: License eligible and willing/able to
obtain licensure within the first year of employment; PA Child
Abuse Clearance required
- Preferred Licensure: Licensed Social Worker (LSW), Licensed
Professional Counselor (LPC), Licensed Marriage and Family
Therapist (LMFT), Licensed Clinical Social Worker (LCSW)
- Relevant Work Experience: Minimum of 3 years of direct clinical
care experience working with adults, children, adolescents and/or
their families in behavioral health settings and experience in
assessment and treatment planning; and/or experience in a managed
- Excellent clinical case conceptualization skills
- Meeting facilitation
- Proactive planning
- Customer service
- Familiar with medications
- Excellent verbal and written communication skills and ability
to use them when communicating with internal and external
- Excellent interpersonal and collaboration skills
- Proficient in MS Office, especially with Excel, and able to
type at least 40 words per minute
- Ability to work independently and as part of a team
- Excellent time management and prioritization skills and ability
- Compliant with HIPAA regulationsPhiladelphia Residency
- The successful candidate must be a current Philadelphia
resident or become a resident within six months of hire. Covid-19
- The safety and well-being of our candidates, our people, and
their families continues to be a top priority. Subject to
applicable law, please be aware that CBH requires all employees to
be fully vaccinated as a condition of employment.Equal Employment
- We strive to promote and sustain a culture of diversity,
inclusion and belonging every day. CBH is an equal opportunity
employer. We do not discriminate in recruiting, hiring, promotion,
or any other personnel action based on all qualified individuals.
This is without regard to race, ethnicity, creed, color, religion,
national origin, age, sex/gender, marital status, gender identity,
sexual orientation, gender identity or expression, disability,
protected veteran status, genetic information or any other
characteristic protected individual genetic information, or
non-disqualifying physical or mental handicap or disability in each
aspect of the human resources function by applicable federal,
state, or local law.Requesting An Accommodation:
- CBH is committed to providing equal employment opportunities
for individuals with disabilities or religious observance,
including reasonable accommodation when needed. If you are hired by
CBH and require an accommodation to perform the essential functions
of your role, you will be asked to participate in our accommodation
process. Accommodations made to facilitate the recruiting process
are not a guarantee of future or continued accommodation once
- If you would like to be considered for employment opportunities
with CBH and have accommodation needs for a disability or religious
observance, please send us an email at PI200672863
Keywords: Community Behavioral Health., Philadelphia , Clinical Care Manager: Psychiatric Emergency Services (Evenings), Executive , Philadelphia, Pennsylvania
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