CRM Integration Specialist jobs in Santa Barbara, CA

Description

Annual Salary Range: $90,347 - $140,037

Job Summary

The Behavioral Health Community Integration Specialist reports to the Behavioral Health Operations Manager and provides care coordination for Members who have a Mental Health disorder, substance use disorder or mental health symptomology. This may include clinical review of medical documents; case management support, care coordination or transition, or a combination of all. The Behavioral Health Community Integration Specialist supports the Behavioral Health Department by supporting community, mental health plan, and provider relationships. The Behavioral Health Community Integration Specialist provides information, referrals, screening of members, and in coordination and collaboration with other teams and entities. The Behavioral Health Community Integration Specialist will be responsible for supporting the Behavioral Health Departments relationship with Santa Barbara County and San Luis Obispo County mental health plan. This includes supporting implementation of the Managed Care Plan responsibilities as outlined in the Memorandum of Understanding with each County Mental Health Plan, supporting the established coordinated referral system, regularly attending, and facilitating meetings. This position is required to attend develop and support relationships within the county mental health plan and support the integration of the CenCal Health Behavioral Health Department in the community.

Duties and Responsibilities

• Facilitate and assist members with accessing mental health care through care coordination and education.

• Care coordinate for regional center members who are identified as needing BHT services.

• Fulfill the Regional Center liaison responsibilities as outlined in the MOU.

• Provide crisis support to members and BH staff.

• Serve as a clinical consultant to Mental Health Providers on case consultations related to member care, mental health benefit, and county referral process.

• Create department, provider, community trainings in collaboration with Department Leadership and Provider Services.

• Facilitate and participate in interdisciplinary care team meetings.

• Adhere to Health plan policies and procedures, HIPAA, privacy and confidentiality laws and regulatory standards.

• Effectively communicate (verbally & in writing) and educate members/providers/vendors about the health care delivery system and health plan benefits and carve out benefits related to behavioral health services and substance use services.

• Empower members by providing community resources, educational materials, and self-managing tools.

• Establish relationships with the County Mental Health contacts and interface on any aspects as it relates to Member Care and compliance requirements.

• Collaborate with County Mental Health, contracted agencies, and community-based organizations to provide supportive services when needed and act as the CenCal Health liaison to both Counties.

• Review, follow and implement the Managed Care Plan Responsibilities as outlined in the County MOU’s.

• Maintain and tracks accurate data, maintains up to date departmental grids/dashboards as required.

• Facilitate and/or attend assigned community meetings that may include County Department of Behavioral Health, FQHC’s, Community Health Clinic, Regional Center to support member access to care and evaluate the current delivery system.

• Effectively communicate verbally and in writing with primary care providers and other health care providers involved in the care of the member.

• Utilize Solution Oriented approaches in communication with providers, stakeholders, and members as part of ongoing quality monitoring and embracing innovative care strategies that build value-based programs.

• Analyze date, prepare for audits, represent department in audits.

• Be abreast clinical knowledge related to mental health, developmental disabilities,

• Provide timely and detailed reports/briefings to supervisor as assigned.

• Other duties as assigned.

Qualifications

Knowledge/Skills/Abilities

Required:

• Professional demeanor.

• Knowledge of DSM-V diagnosis and evidenced based treatment approaches.

• Knowledge of County level Mental Health services and community resources.

• Demonstrate strong multi-tasking, organizational, and time-management skills.

• Able to work effectively individually and collaboratively in a cross-functional team environment.

• Work with a high degree of independence, while seeking guidance when necessary and escalating issues to immediate supervisor early.

• Must be able to handle multiple projects at one time, reset priorities day to day to meet deadlines. Know when to ask for assistance and direction when working with conflicting priorities.

• Able to communicate professionally by phone, with members and their families, physicians, providers, and other health care providers; in writing, and in-person (in a one-to-one or group setting) and to demonstrate excellent interpersonal communication skills.

• Able to compose clear, professional, and grammatically correct correspondence to members and providers.

• Able to meet timelines/deadlines of daily work responsibilities and, as assigned, for long-term projects.

• Utilize computer and appropriate software and job specific applications/systems.

• Work with all levels of staff to identify and problem-solve contracted provider issues.

Desired Overall:

• Knowledge of Medi-Cal and/or Medicare health care benefits, managed care regulations, including benefits and contract limitations, delivery and reimbursement systems, and role of medical management activities

• Understand basic utilization review principles and practices.

• Understand basic case and disease management concepts, principles and practices as described in the Case Management Society of America

• Understand basic quality improvement and population health concepts, principles, and practices.

Education and Experience

Required for Behavioral Health County Liaison (Mental Health Team):

• Master’s Level license or registered AMFT, ASW, APCC.

• 2 years’ experience with case management, care coordination including suicide assessment and screening.

• 1-2 years post graduate experience working with Medi-Cal population and/or County Department of Behavioral Health.

Desired:

• Bilingual in Spanish

• 4 years post graduate experience working with substance use, social work, or in the behavioral health field.

• Preferred Licensure: LCSW, LMFT, or LPCC.

• Prior experience in a managed care setting.