Behavioral Health Access Guide

Overview

To coordinate medically necessary behavioral health treatment services for adults and children with behavioral health needs. Screens, collaborates and coordinates care as part of the multidisciplinary team to evaluate and advocate for the medical, behavioral and psychosocial needs of the member while promoting quality outcomes.

• Assists with a specialized case load of members with behavioral health needs which interfere with positive healthcare outcomes.
• Collaborates and consults with care providers, members, and/or the multidisciplinary care team to assist in understanding the member’s behavioral health needs.
• Acts as a support/resource to others within the organization for behavioral health cases.
• Receives phone calls from members seeking behavioral health services.
• Screens members using proscribed screening tools and directs members to appropriate providers.
• Knowledge of and ability to coordinate with multiple systems of care including county-based behavioral health services.
• Functions collaboratively in a team environment.
• Utilizes best practices in coordination of behavioral health services in accordance with established guidelines associated with access line workflows.
• Coordinates with medical providers, psychiatrists, drug and alcohol counselors, case managers, and other support staff to ensure continuum of care.
• Performs screenings to assist in coordinating behavioral health services.
• Maintains accurate and timely documentation, records, and case files in the Partnership Health Plan of Californica (Partnership) Case Management System for members in behavioral health access line management system.
• Develops and maintains knowledge of a community based network of alternative modes of care. Aids member to connect with community-based organizations to support and enhance wellness.
• Communicates clearly and effectively through all mediums of communication with members, providers, vendors, community partners, and Partnership employees.
• Supports successful transition of care for members discharged from a residential setting transitioning to a lower level of care within the community, to include assessing member needs and identifying appropriate staff to carry out identified needs, effective and frequent communication with providers, members, county partners and identified health care designee.
• Performs other duties as assigned including the assumption of new duties.

High school diploma or equivalent combination of education and experience required; associates or bachelors degree preferred. Two (2) years of experience in the delivery of care and services that address behavioral health needs of individuals from diverse populations. Demonstrated skill in using evidence-based principles, methods and techniques to address mental health and substance use disorders across multiple care settings.

Ability to actively listen, engage members who may be having active behavioral health challenges by using motivational interviewing techniques. Considerable knowledge of prevention, treatment and rehabilitation techniques used in the identification and treatment of mental illness and emotional disorders. Federal, state and local laws, rules and regulations associated with mental health treatment and education programs. Understanding of the treatment of mental illness and substance use disorders.

Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business. Bilingual skills in Spanish, Tagalog, or Russian are preferred.

Performance Based Competencies

Strong organizational, communication, attention to detail and critically thinking skills required. Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and meeting deadlines. Ability to work across systems of care and engage members and providers to coordinate care and services. Effective telephone and computer data entry skills required. Experience in managed care business…