Description
This is a full-time field teleworker position that requires West Virginia residency.
The role involves utilizing critical thinking and judgment to collaborate and inform the case management process, to facilitate appropriate healthcare outcomes for members by providing care coordination, support, and education for members through the use of care management tools and resources.
Responsibilities:
- Conduct comprehensive evaluation of referred member's needs/eligibility and recommend an approach to case resolution and/or meeting needs
- Identify high risk factors and service needs that may impact member outcomes and care planning components
- Coordinate and implement assigned care plan activities and monitor care plan progress
- Consult with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives
- Identify and escalate quality of care issues through established channels
- Utilize negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs
- Provide coaching, information, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices
Requirements:
- 2 years' experience in behavioral health, social services, or appropriate related field
- West Virginia resident residing in one of the following counties: Barbour, Brooke, Doddridge, Hancock, Harrison, Lewis, Marion, Marshall, Monongalia, Ohio, Pleasants, Ritchie, Taylor, Tyler, Upshur, Wetzel
- Must possess reliable transportation and be willing and able to travel in the assigned region 50% or more of the time
- 2+ years of experience with personal computer, keyboard, mouse, multi-system navigation; and MS Office Suite applications (Outlook, Word, Excel, SharePoint, Teams)
Preferred Experience:
- Medicaid experience
- Waiver experience
- Foster care experience
- Crisis intervention skills
- Managed care/utilization review experience
- Case management and discharge planning experience
- Familiarity with QuickBase
Education:
- Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling)
Benefits:
- Medical, dental, and vision coverage
- Paid time off
- Retirement savings options
- Wellness programs