Service Coordinator - Behavioral Health (Hybrid)

• Medical - Active Day 1 of hire
• Dental
• Vision
• Life Insurance
• Disability Insurance
• Mandatory Savings Plan
• Flexible Spending Accounts
• Paid Personal Leave
• Tuition Reimbursement
• Employee Health Center
• And more!
  Job Summary:Service Coordination
• Conducts service coordination and care management activities according to model of care, program description and policies and procedures to provide timely, quality care and services to members with physical and/or behavioral health needs.
• Evaluates member needs and available resources to facilitate the development of a care plan that will contribute to the best health outcomes for the member/family.
• Monitors care plans, member status and outcomes and provides recommendations to care plan based on identified member needs and goals, as applicable.
• Coordinates between the member and/or family/caregivers and the provider care team, as applicable, to ensure member accessibility to identified services.
• Completes case interventions according to time and completeness requirements and documents all actions and decisions.
• Maintains directory of community resources and provides resource support to members and their families/caregivers.
• Provides education to members and their families/caregivers on procedures, provider instructions, treatment options, referrals, and healthcare benefits, including behavioral health.
• Functions as liaison with member's providers. Quality
• Integrate health literacy principles into all communication including Members and Providers.
• Support strategies that meet clinical, quality and network improvement goals.
• Promote the use of Health Information Technology to support and monitor the effectiveness of health and social interventions and make data-driven recommendations as needed.
• For staff in clinical roles, foster collaborative relationships with members and/or providers to promote and support evidence-based practices and care coordination. Regulatory and Compliance
• Ensures work is carried out in compliance with regulatory and/or accreditation standards as well as contractual requirements.
• Participates in self-audits and peer reviews to ensure compliance with regulations, standards, and departmental policies and provide feedback for the Service Coordination training program.Professional Accountability
• Promotes and supports a culturally welcoming and inclusive work environment.
• Acts with the highest integrity and ethical standards while adhering to Parkland's Mission, Vision, and Values.
• Adheres to organizational policies, procedures, and guidelines.
• Completes assigned training, self-appraisal, and annual health requirements timely.
• Adheres to hybrid work schedule requirements.
• Attends required meetings and town halls.
• Recognizes and communicates ethical and legal concerns through the established channels of communication.
• Demonstrates accountability and responsibility by independently completing work, including projects and assignments on time, and providing timely responses to requests for information.
• Maintains confidentiality at all times.
• Performs other work as requested that is reasonably related to the employee's position, qualifications, and competencies.
• Proficient in medical and managed care terminology.
• Competent in the application of integrated service coordination (care management) standards.
• Familiar with auditing processes and regulatory/accreditation requirements (TDI, HHSC, NCQA, CMS).
• Proficient computer and Microsoft Office skills. Ability to learn new software programs,
• Knowledge of Texas Medicaid, National Committee for Quality Assurance (NCQA), the Uniformed Managed Care Contract, and the Uniform Managed Care Manual.Minimum Qualifications:
  • BSN Degree from and accredited Professional School of Nursing- OR -Master of Social Work (MSW) Degree from an accredited program.
  • For roles primarily serving members with behavioral healthconditions, master's degree in social work, or related field preferred.
  • At least 3+years of experience practicing behavioral health (social work, counseling, etc.) is required.
  • 3+ years of care management experience in a health plan setting or managed care organization is preferred.
    Equivalent Education and/or Experience:
  • May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above.Certification/Registration/Licensure:
    • Must have and maintain current, valid RN license or temporary RN license from the Texas Board of Nursing, or valid Compact RN license or LBSW, LMSW, or LCSW.
    • If primarily serving members with Behavioral Health conditions, must have a valid RN license from the Texas Board of Nursing or compact RN license or LPC, LMFT, LBSW, LMSW or LCSW in the State of Texas.
    • Certified Case Manager (CCM) credential in case management preferred.Parkland Community Health Plan (PCHP) prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.

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