Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This job provides telephonic integrated behavioral and physical health case and condition management services to members with mental health, substance use, and co-morbid chronic medical conditions. Behavioral health conditions include serious mental illness, untreated mental health, alcohol use, and opioid use. The incumbent uses clinical and motivational interviewing skills to assess both behavioral and physical health needs, and social determinants of health to establish mutually agreeable short and long-term health goals. They support members in developing self-management skills and adopting positive behavior change; identify and address gaps in care; resolve barriers to evidence-based care; help members coordinate their comprehensive healthcare services and navigate the healthcare system; and identify on-line, telephonic, and community-based resources. The overall goal is to help members navigate the health care system and develop condition self-management skills through behavior change

ESSENTIAL RESPONSIBILITIES

• Function as a primary contact for members with Opioid Use Disorder (OUD)/Behavioral Health with co-morbid medical conditions including pregnancy to provide intensive case management interventions. Provide members with resources and tools to assist in health-related decision making. Conduct clinical and psycho-social assessments telephonically or in the community that address the health and wellness needs of the Organization's members.

• Collaborate with case and condition management teams to provide co-management activities for members who require additional services. Participate in ongoing training and educational activities related to behavioral health and medical topics. Pro-actively incorporate lifestyle improvement and prevention opportunities into member interactions and coaching. Provide education on evidenced based treatment.

• Utilize standard case management approach to manage members’ conditions (Motivational interviewing; Develop plans of care; Establish a plan for contact to review progress/assess needs; Communicate with treating provider(s); Identify community-based resources for long-term maintenance).

• Assess for social determinants of health and link members with community resources to eliminate barriers.

• Collaborate with key community and clinical partners.

• Other duties as assigned or requested.

EDUCATION

Required

• High School Diploma/GED with RN license

OR

• Master’s Degree if Licensed Behavioral Health Professional or Licensed Social Work

Substitutions

• None

Preferred

• None

EXPERIENCE

Required

• 5 years of Post licensure experience in any combination of behavioral health clinical, case management and/or condition management

Preferred

• 5 years of Advanced training and experience in cognitive behavioral therapy (CBT) and or DBT

• 5 years of Experience working with healthcare needs of populations with SMI and substance use disorders

• 5 years of Experience working with the healthcare needs of diverse populations

• 5 years of Understanding of the drug and alcohol system, harm reduction and community resources

• 5 years of Crisis management

• 5 years of Understanding how SMI, addiction, and medical co-morbidities affects families

• Proficiency in a second language

LICENSES or CERTIFICATIONS

Required

One of the following:

• Registered Nurse (RN)

• Licensed Professional Counselor (LPC)

• Licensed Clinical Social Worker (LCSW)

• Licensed Social Worker (LSW)

• Licensed Marriage and Family Therapist (LMFT)

Preferred

• Certified Case Manager

• CAC - Certified Addiction Counselor

SKILLS

• Advanced knowledge of motivational interviewing and stages of change

• Proficiency in utilizing PC-based system application and reporting packages, especially Microsoft Office application

• Understanding of confidentiality laws as they pertain to Drug and Alcohol and Behavioral Health

• Knowledge of evidenced based practices as it relates to treatment of SMI/OUD/behavioral health

• Excellent verbal and written communication skills as well as the ability to manage multiple priorities in a rapidly changing environment

Languages (Other than English)

None

Travel Required

None

PHYSICAL, MENTAL AND WORKING CONDITIONS

Position Type

Office Based

Teaches / trains others regularly

Does Not Apply

Travel regularly from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Rarely

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$67,500.00

Pay Range Maximum:

$124,800.00

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J242980