Behavioral Health Case Management Liaison

Behavioral Health Case Management Liaison

The Behavioral Health Case Management Liaison manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability. Acts as provider liaison to oversee the Community Based Case Management (CBCM) Agencies who deliver and coordinate the behavioral services of the CCS contract. Monitors CCS contract compliance with the CBCM Agencies by collecting clinical data and maintaining accurate records for tracking and metric purposes.

• Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability.
• Acts as provider liaison to oversee the Community Based Case Management (CBCM) Agencies who deliver and coordinate the behavioral services of the CCS contract.
• Identification and tracking of all assigned members of assigned CBCM agencies.
• Audits member records for compliance of CCS contract.
• Collects clinical data and maintains accurate records for tracking and metric purposes.
• Oversees CCS contract compliance of the CBCM agencies (i.e. Behavioral Health Assessment (BHA)/Individualized Treatment Plan (ITP) received within specified time frames, quarterly BHS reports, post hospitalization follow up, etc.).
• Maintains ongoing contact with assigned CBCM agencies. Participates in agency educational meetings and agency visits.
• Facilitates enrollment and eligibility changes.
• Monitors and oversee the HSH provisional enrollment process.
• Notifies CBCM Agency when a member is admitted for a Behavioral Health Inpatient Hospitalization.
• Reviews authorization requests for CCS program benefits.
• Serves as Officer of the Day (OOD) to address calls from customer service and internal ‘Ohana staff.
• Processes Adverse Events.
• Coordinates with members’ QUEST Integration Health Plan Service Coordinator for continuity of care.
• Holds Interdisciplinary Team (IDT) Meetings for complex, high-risk, high-utilizing members and participates in departmental clinical rounds.
• Responsible for maintaining Aloha Care’s confidential information in accordance with Aloha Care policies, state and federal laws, rules and regulations regarding confidentiality. Employees have access to Aloha Care data based on the data classification assigned to this job title.

• Master’s degree in social work, Psychology, Counseling, Rehabilitation, or another relevant field.
• Licensed RN, LCSW, LMHC, LMFT, APRN, or Licensed Psychologist in the State of Hawaii.
• Minimum of 2 years of experience in behavioral health management and/or acute behavioral health care setting focusing on outpatient/inpatient utilization, case management and discharge planning.
• Minimum of 1 year experience in case management as a licensed professional.
• Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs.
• Able to effectively work in a fast-paced and changing environment, manage multiple projects and priorities across multiple teams/projects and in a matrixed environment.
• Possesses excellent time management and organizational skills; dependable, enthusiastic, self-starting, and self-motivated. Uses time effectively, reacts professionally under pressure.
• Experience in a managed care environment.
• Work evenings and weekends as needed as the need for services arises.
• May require prolonged sitting – up to 4 hours.
• Requires prolonged operation of a computer workstation, including the ability to type for extended periods of time on a keyboard during the scheduled workday.

Aloha Care’s comprehensive benefits package includes low-cost medical, dental, drug and vision insurance, paid time-off, 401(k) employer contribution, referral bonus and pretax transportation and parking program.

Salary Range: $70,000 - $83,000 annually