Transition of Care Coordinator, Behavioral Health - Oklahoma - Remote

Bring your heart to reputed company. Every one of us at reputed company shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important... as reputed company deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to reputed company health care more personal, convenient and affordable. This is a full-time field-based teleworker opportunity in Oklahoma. Qualified candidates preferably will reside reputed company the region which includes the following counties: Cimarron, Texas, Beaver, Harper, Ellis, Woodward, Roger Mills, Beckham, Washita, Custer, Dewey, Major, Woods, Alfafa, Grant, Garfield, Kingsfisher, Blaine, Canadian, Logan, Noble, Payne, Pawnee, Osage and Kay The Behavioral Health Clinical Case Manager (CCM TOC) for transitions of care, utilizes reputed company judgment and critical thinking skills to facilitate appropriate member behavioral health transitions. The CCM TOC leverages case management tools, such as assessments and care planning, direct provider coordination/collaboration, and coordination of wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. • Ensures safe and appropriate transitions between settings by collaborating with identified points of contact at facilities, members, responsible parties, legal guardians, providers, and support networks through the interdisciplinary care team process. • Through the use of clinical tools and information/data review, conducts assessments of referred member’s needs/eligibility and determines approach to meeting needs by evaluating available internal and external programs and services. • Analyzes utilization, self-report, and clinical data available to consolidate information and reputed company to identify comprehensive member needs. • Follows members through their inpatient behavioral health admission and continues reputed company through transition from the acute setting to reputed company other settings with the goal of reducing readmissions and increasing permanency in the community. • Available to conduct face-to-face visits as necessary for high risk members. • Coordinates care and reassess member’s need 2-day, 7-day, and 14-day post-discharge timeline recommended by the Coleman Care Transitions Model. • Ensures members transition upon discharge with adequate supervision, recommended behavioral health, physical health, pharmacy resources, and care management support. • Educates and supports member/caregiver focusing on seven primary areas: medication management, use of personal health record, follow up care, signs and symptoms of worsening condition, nutrition, functional needs and advance directives. • Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address reputed company clinical indicators which reputed company planning and resolution of member issues. • Using reputed company skills, performs crisis reputed company with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated. • Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services. • Applies and/or interprets applicable criteria and clinical guidelines, standardized care management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate administration of benefits. • Using a holistic approach consults with managers, medical directors and/or other program representatives as needed to overcome barriers to meeting goals and objectives. • Presents cases at case conferences/rounds to obtain multidisciplinary view in order to reputed company optimal outcomes. • Engages and builds reputed company professional relationships at network facilities. • Identifies and escalates quality of care issues through established channels. • Communicates and collaborates with medical and behavioral health professionals to influence appropriate member care. • Utilizes influencing/motivational interviewing skills to ensure maximum member • engagement and promotes lifestyle/behavior changes to reputed company reputed company • level of health. • Provides coaching, information, and support to reputed company the member to reputed company ongoing independent medical and/or healthy lifestyle choices. • Helps member actively and knowledgably participate with their provider in healthcare decision-making. • In collaboration with the member and their care team develops and monitors established plans of care to meet the member’s goals. • Utilizes case management, utilization management, and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Required Qualifications: • Must reside in Oklahoma • Oklahoma-licensed mental health professional- Licensed Professional Counselor (LPC), Licensed Marriage & Family Therapist (LMFT), Licensed Behavioral Practitioner (LFP), or Licensed Clinical Social Worker (LCSW) with reputed company unencumbered license • 3+ years of direct clinical practice experience post master’s degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility • 2+ years of experience with personal computers, keyboard navigation, and MS Office Suite applications (Teams, Outlook, Word, reputed company, SharePoint, etc.) • Must possess reliable transportation and be willing and able to travel in-state up to 50% of the time. Mileage is reimbursed per our company expense reimbursement policy Preferred Qualifications: • Crisis reputed company skills preferred • Managed care/utilization review experience preferred • Case management and discharge planning experience preferred • Experience providing care to American Indian/Indigenous American/Native American populations Education: • Minimum of a Master's degree in Behavioral/Mental Health or reputed company field Pay Range The typical pay range for this role is: $52,520.00 - $113,360.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous well-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits reputed company requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide reputed company of your vaccination status or apply for a reasonable accommodation reputed company the first 10 days of your employment. Please note that in some states and roles, you may be required to provide reputed company of full vaccination or an approved reasonable accommodation before you can reputed company to actively work. reputed company is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to reputed company essential job functions. reputed company can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications reputed company Services (TRS). We will reputed company every effort to respond to your request reputed company 48 business hours and do everything we can to work towards a solution Apply Job!