Responsibilities
- Supporting utilization management functions for more complex and non‑routine cases as needed.
- Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs.
- Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits.
- Performing the essential activities of case management: assessment, planning, implementation, coordinating, monitoring, outcomes and evaluation.
- Perform case management activities in community settings including face to face with members as required.
Requirements
- Current, active unrestricted Tennessee license in Nursing (RN) or behavioral health field (Master's level or above) required.
- 3 years - Clinical behavioral health / substance use disorder experience required.
- 1 year - Must be knowledgeable about community care resources and levels of behavioral health care available.
- Experience with Motivational Interviewing Techniques and Adult Learning Styles.
- Currently has a Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire.
- Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint).
Hard Skills
- clinical behavioral health
- substance use disorder
- case management
- assessment
- planning
- implementation
- coordinating
- monitoring
- outcomes evaluation
- motivational interviewing
Soft Skills
- liaison
- communication
- coordination
- interpersonal skills
- organizational skills
Certifications & Qualifications
- Tennessee nursing license
- Certified Case Manager (CCM)
Industry Keywords
- utilization management
- community care resources
- behavioral health care
- health care delivery
- benefits programs
Tools & Technologies
- Microsoft Office
- Outlook
- Word
- Excel
- PowerPoint
BH Case Manager – Federal Employee Program Arbeitgeber: Jobtailor
Als Global Director B2B – Business Development bei uns profitieren Sie von einer dynamischen und innovativen Arbeitsumgebung, die auf Zusammenarbeit und Kreativität setzt. Wir bieten Ihnen nicht nur attraktive Vergütungsmodelle und umfassende Weiterbildungsmöglichkeiten, sondern auch die Chance, in einem internationalen Team zu arbeiten, das Vielfalt und persönliche Entwicklung fördert. Unsere Unternehmenskultur legt großen Wert auf Flexibilität und Work-Life-Balance, sodass Sie Ihre Karriereziele in einem unterstützenden Umfeld erreichen können.
