Case Manager - Behavioral Health

## Case Manager - Behavioral Health Apply locations:
Providence, RItime type:
Full time posted on:
Posted Yesterday job requisition :
JR100394
** Pay Range:**$73,600.00 - $Please email
** HR Talent Acquisition Team
** if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
** At BCBSRI, our greatest resource is our people.
** We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.
** We recognize that to do your best work, you have to be your best self.
** It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.
** Our culture is one of belonging.
** We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued.
** Join others who value a workplace for all.
** We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.
** We’re dedicated to serving Rhode Islanders.
** Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.

Must be commutable distance to Providence, RI
** Why this job matters:
** Assist members in navigating the behavioral healthcare system, ensuring access to evidence-based care. Educate, empower, and coordinate services for members to improve their health and well-being. Facilitate communication between patient, provider, and health plan to ensure members receive the full benefit of integrated care.
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* What you will do:

*** Manage members through the behavioral healthcare delivery system; assess needs in order to identify appropriate interventions.
* Conduct telephonic or face to face health assessments to identify high risk or emerging risk members who would benefit from education and intervention.  Facilitate communication between members, providers, and stakeholders to coordinate and implement action plans aimed at improving the members’ total health.
* Identify opportunities to impact claims expense trends for all lines of business/or at the individual member level.
* Evaluate action plans by working with members and collaborating with providers.  Modify action plans as necessary.
* Monitor and evaluate patient services to ensure appropriate coordination of care.  Collaborate with the Utilization Review process including pre-authorization, concurrent review, screening cases for quality-of-care issues, and discharge planning.  .
* Promote member and provider satisfaction by demonstrating working knowledge of member benefits, including but not limited to health, disability, Employee Assistance, or other plans/benefits available to the member
* Provide continuity and consistency of care by building positive relationships between the member and family, physicians, provider, care coordinator, and health care plan.
* Work collaboratively with the team and others necessary to…