Behavioral Health Case Manager

HealthPartners is hiring a Behavioral Health Case Manager. This position exists
to provide support to patients, their families, and physicians in addressing
behavioral health and social concerns; educate and empower patients and families
to make informed personal health care decisions; and facilitate communication
between patient, physician, health plan and community.

Accountabilities

Member Focus

1. Ensures all activities are member-focused and individualized, resulting in
personalized attention to each patient’s unique needs.
2. Identifies interventions and resources to assist member reaching personal
health related goals.
3. Identifies patterns and episodes of care that are predictive of future needs
and services.

Integration

1. Integrates clinical and psychosocial information for case identification and
individual patient assessment to develop action-oriented and time-specific
planning and implementation of appropriate interventions.
2. Facilitates integration of patient care by encouragement of effective
communications between patients, families, providers, health plan and care
system programs, and community-based services. 
3. Adheres to policy and procedure in daily activities. 
4. Coordinates service coverage with appropriate funding sources when
indicated.

Communication

1. Effectively and routinely communicates with patients, families, physicians
and health care team members to facilitate successful collaboration
resulting in high levels of member/patient/family/provider satisfaction.
2. Provides regular reporting of member outcomes to behavioral health
leadership according to defined process.
3. Identifies and promptly reports potentially adverse situations to department
leadership.
4. Identifies and promptly reports high cost cases for reinsurance.
5. Maintains confidentiality of information in accordance with department and
corporate policies.

Relationships and Team Building

1. Establishes and maintains good working relationships within the Behavioral
Health Improvement and Operations Department, with other HealthPartners
Departments, and with other health team participants. 
2. Supports other team members in achieving patient centered goals.
3. Assists supervisor in maintaining a cohesive team by contributing to a
collaborative, respectful, and diverse environment.
4. Participates in and contributes to appropriate departmental and/or
organizational meetings.
5. Acts as a liaison between internal customers, Marketing, Sales, Claims and
Member Services to resolve systems/process issues.

Technology

1. Maintains knowledge of and effectively uses automated applications and
systems.
2. Identifies deficits in technological literacy and seeks appropriate training
under guidance of supervisor.
3. Maintains maximum individual productivity through proficient use of
automated systems.

Personal Development

1. Participates in ongoing independent study and education-related professional
activities to maintain and increase knowledge in the areas of case
management, patient care services, and benefit packages for development of
effective case management skills.
2. Demonstrates responsiveness to and appreciation of constructive feedback and
recommendations for personal growth and development.
3. Maintains current, active Minnesota licensure.

Other Duties

1. Willingly participates in various committees, task forces, projects, and
quality improvement teams, as needed and assigned.
2. Performs other duties as assigned.

Required Qualifications

1. Licensed in Minnesota as LICSW, RN or Psychologist, Masters degree
preferred.
2. Minimum of 3 years clinical practice experience; minimum of 3 years relevant
utilization review, discharge planning, or case management experience; and
current clinical knowledge.
3. Demonstrated effective, clinical judgement and skills.
4. Demonstrated skill and experience in effectively collaborating with care
team members, using a high level of expertise in written, oral and
interpersonal communication.
5. Demonstrated working knowledge of QI, UM, benefit plans fiscal management,
and various payment methodologies preferred. Understanding of healthcare
and/or HMO industry.
6. Demonstrated skill in effective use and management of automated medical
management systems.
7. Demonstrated flexibility, organization, and appropriate decision-making
under challenging situations.
8. Ability to organize and prioritize multiple assignments within workload.
9. Ability to deal with change and ambiguity.

Decision-Making

1. Makes independent decisions within the scope of this position’s
accountabilities and determines the need for and the timing of consultation
with behavioral health leadership.
2. Uses sound judgement, organizational knowledge, industry knowledge, and
common sense in determining appropriate alternatives for
members/patients/families, consulting with leadership and/or Medical
Director, when indicated. 
3. Utilizes the member contract coverage policy on-line benefits, level of care
guidelines and Member or Claims Services on-line policies and procedures. 
4. Makes recommendations to leadership regarding policy development needs
and/or changes.

Major Challenges

1. Maintaining member focus in a rapidly evolving environment.
2. Influencing team members and colleagues to work collaboratively in achieving
the goals and objectives of the department.
3. Maintaining timely, comprehensive reviews with concise documentation of
pertinent facts, decisions and rationale.
4.. Maintaining appropriate use of supervisory and consultation resources

At HealthPartners we believe in the power of good – good deeds and good people
working together. As part of our team, you’ll find an inclusive environment that
encourages new ways of thinking, celebrates differences, and recognizes hard
work.

We’re a nonprofit, integrated health care organization, providing health
insurance in six states and high-quality care at more than 90 locations,
including hospitals and clinics in Minnesota and Wisconsin. We bring together
research and education through HealthPartners Institute, training medical
professionals across the region and conducting innovative research that improve
lives around the world.

At HealthPartners, everyone is welcome, included and valued. We’re working
together to increase diversity and inclusion in our workplace, advance health
equity in care and coverage, and partner with the community as advocates for
change.

Benefits Designed to Support Your Total Health
As a HealthPartners colleague, we’re committed to nurturing your diverse
talents, valuing your dedication, and supporting your work-life balance. We
offer a comprehensive range of benefits to support every aspect of your life,
including health, time off, retirement planning, and continuous learning
opportunities. Our goal is to help you thrive physically, mentally, emotionally,
and financially, so you can continue delivering exceptional care.

Join us in our mission to improve the health and well-being of our patients,
members, and communities.

We are an Equal Opportunity Employer and do not discriminate against any
employee or applicant because of race, color, sex, age, national origin,
religion, sexual orientation, gender identify, status as a veteran and basis of
disability or any other federal, state or local protected class.