TEMPORARY FULL-TIME AND PART-TIME POSITIONS AVAILABLE.
PRO-RATED BENEFITS OFFERED FOR 29-40 HOURS A WEEK.
At Comagine Health, we work to improve health and create a better health care system so that people and communities will flourish. Our care management services result in better clinical outcomes, higher patient satisfaction, and increased cost savings. Our approach is customized for each client using evidence-based criteria and medicine, data analysis, and deep clinical and technical proficiency.
We’re proud to have been selected by the Oregon Health Authority (OHA) to provide statewide eligibility determination, service coordination, medical appropriateness reviews, and transition planning for individuals diagnosed with serious and persistent mental illness (SPMI). In partnership with OHA, Comagine Health is committed to ensuring that individuals with SPMI receive the right care in the right setting based their specific needs. We welcome you to join us in our mission to improve population health and eliminate health disparities for vulnerable populations.
Our goal is to support adults with SPMI to live in the least-restrictive settings possible by ensuring that necessary and desired supports and services are in place. This important work is accomplished through administering face-to-face assessments, person-centered service planning (in partnership with individuals and their designated agents), continuous monitoring of service plans, and assisting with transitions from and between community and institutional settings. As our BEHAVIORAL HEALTH CASE MANAGER, you would:
- Conducts initial, annual, and as needed face-to-face assessments to create and maintain a tailored PCSP, utilizing LOCUS, the LSI, and review of records. *TELEMEDICINE WILL BE UTILIZED FOR SERVICE DELIVERY WHEN APPROPRIATE, ESPECIALLY DURING COVID-19 CONTACT RESTRICTIONS AND WHEN WORKING WITH INDIVIDUALS IN RURAL AREAS.
- Provides advocacy to individuals (and authorized representatives and supports) regarding assessment, patient-centered service planning, service coordination, and transition planning
- Assists in eligibility determinations as needed
- Works closely with individuals, providers, facilities, and social service and community organizations to assist individuals in accessing appropriate care
- Ensures care is being delivered as described in the PCSP, working with providers and individuals to correct services or adjust the PCSP as needed
- Performs prior authorizations for services
- Applies clinical review criteria, guidelines, and screens to determine the medical necessity of health care services
- Consults with physicians or practitioner consultants when reviews fail clinical review criteria, guidelines, and screens
- Follow all determinations, appeals and hearings policies, processes, and contract requirements
CORE BEHAVIORS:
- Can work in unpredictable environments
- Is a settling influence in a crisis
- Genuinely cares about people
- Is sympathetic to the plight of others
- Utilizes active stress management/coping strategies
- Demonstrates empathy
- Builds rapport well
- Is a good listener
- Is easy to approach and talk to
Required Skills
- Demonstrated ability to conduct a behavioral health assessment including the identification of precipitating events, including health and safety risks to self or others
- Competent in gathering histories of mental and physical health, substance use, and criminal justice system
- Ability to conduct a mental status examination
- Competent in providing DSM 5 diagnoses
- Proficient in developing treatment plans and safety plans
- Oregon Medicaid knowledge, and knowledge of Oregon Health Plan’s Prioritized List of Health Services preferred
Required Experience
- Experience working with individuals with severe and persistent mental illness (SPMI)
- Experience with utilization review (or other medical management experience) preferred
- Behavioral health clinical setting experience preferreds preferred
- Graduate degree in social work, psychology, or other behavioral health science field; Bachelor’s degree in nursing and licensed by the State of Oregon (with relevant training in behavioral health service delivery)
- Qualified Mental Health Professional (QMHP) with designation (QMHP-C or QMHP-R); or Current, active, unrestricted clinical licensure required.