||Posted: ||Tuesday, June 26, 2012
|Expires: ||Monday, June 16, 2014|
|Job Title: ||Clinical Care Manager - LCPC or LCSW License Required|
|Job Location: ||Chicago, IL |
|Type of Position: ||Full-Time Permanent|
|Number of Openings: ||2|
|Annual Salary: ||from $52,000 to $56,000|
|Starting Date: ||ASAP|
|Education Required: ||Masters|
|Years of Experience Required: ||3|
|Overnight Travel: ||None|
|Vacation Time: ||2 weeks / year|
|Options: ||Health/Dental Benefits · Paid Holidays, Vacations, and Sick Leave · Life and/or Disability Insurance · Casual Dress|
|More about the job:||Main Function:
Conducts telephonic assessments, collecting sufficient data to make appropriate referral and to determine if the appropriate levels of care and service criteria are met. As needed, collaborates and coordinates with providers, consumers, and the treatment team to evaluate clinical appropriateness of treatment and interventions. Assists with the management of treatment across the continuum of care. Ensures treatment provided is timely, and designed to meet the Consumer’s individual needs. Works with providers and facilities to monitor and evaluate care at regular intervals to ensure progress towards goals. Uses State of Illinois approved ValueOptions’ clinical policies and procedures and clinical criteria to provide administrative services within benefits. As needed, provides mentoring of non-clinical staff.
Essential Duties and Responsibilities:
1. Responsible for clinical decisions related to assessment, referral, coordination of care, and appropriateness of care for consumers seeking access to their benefits for Mental Health or Substance Abuse services for all levels of care covered by contracts, using established criteria, guidelines and policies. This includes providing support and educational information to providers to assure that cases meet all contract requirements and pending cases that do not meet medical necessity criteria to a peer advisor when unable to render a certification decision.
2. Responsible for triage and management of emergency calls.
3. Responsible for meeting standards related to: clinical documentation, clinical policies and procedures, accreditation and regulatory standards and contract compliance. These standards will be defined by the Service Center to meet expectations for the business served and may include things such as:
100% compliance with UM decision TAT
100% compliance with UM review standards
100% compliance with phone call management expectations
<1 authorization error/week
Able to put notes directly into computer system in real time
Able to take on and appropriately execute additional projects or task force meetings
Displays productivity at current standards
Passes the Inter-rater Reliability test
4. Actively participates in clinical rounds/case review process, and seeks consultation with the Clinical Director and Medical Director as needed.
5. Actively participates in the designated processes to manage the care of high risk consumers.
6. When necessary, responsible for clinical oversight of activities performed by non-licensed staff members.
7. Maintains confidentiality and ethical and professional standards.
8. Performs other duties as assigned.