Behavioral Health Clinician, Post Discharge

Location: This position is located at our Dublin, OH campus with hybrid flexibility.

Who we are

Founded in 1999 and headquartered in Central Ohio, we’re a privately-owned, independent healthcare navigation organization.We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective for our millions of members. Our big-hearted, tech-savvy team fights to ensure that our members get the care they need, when they need it, at the most affordable cost – that’s why we call ourselves Healthcare Warriors®.

We’re committed to building diverse and inclusive teams – more than 2,000 of us and counting – so if you’re excited about this position, we encourage you to apply – even if your experience doesn’t match every requirement.

About the role

The Behavioral Health Care Clinician, Post Discharge provides support to members discharging from behavioral health/substance abuse levels of care as indicated per the Health Benefit Plan. Care coordination services are facilitated post discharge to ensure that members have a safe and effective transition to the next level of care.

What you’ll do

• Interpret available clinical data to determine appropriateness of post discharge call outreach.
• Conduct post discharge calls to members that have been engaged in recent mental health/substance abuse treatment.
• Utilize and update electronic records as appropriate.
• Assess members for aftercare appointments with providers and/or programs.
• Assist in finding appropriate aftercare providers and/or programs, if applicable.
• Verify network status of providers and programs and re-direct, as needed.
• Assess members for mental health crisis states by utilizing PHQ2 and respond appropriately to ensure wellbeing and safety.
• Assess psychosocial support system. Provide support and resource assistance to member’s family, caregiver and/or support system as needed.
• Assess crisis/safety and/or relapse prevention plans and provide education or resources when applicable.
• Confirm members have crisis numbers.
• Assist members with navigating barriers to adhering to medication regimens.
• Interpret plan benefits and educate members as needed.
• Research and educate members on condition specific resources with the health plan and in the community for continued support and optimal well- being.
• Provide member education regarding the different levels of care, need for continuation of care, medications and/or additional topics.
• Assess that home is a safe environment and educate or provided resources, as needed.
• Provide advocacy for the member and/or health plan.
• Maintain a working knowledge of all policies and procedures related to Clinical Operations – Behavioral Health.
• Maintain a working knowledge of employer health benefit plans and where to access the benefit information.
• Maintain success stories which can be shared with clients and promotion of program.
• Educate internal work groups on mental health/substance abuse treatment forms and levels.
• Support internal work groups in locating appropriate treatment providers and programs for members.
• Collaborate with internal clinical staff for transfer or referral of cases for medical management when appropriate.
• All other duties as assigned.

What you’ll bring

• Registered nurse with active license in Ohio or Licensed Social Worker with active license in Ohio
• Minimum of 4 years of experience in a Behavioral Health setting
• Have a working knowledge of nationally accepted Behavioral Health medical necessity criteria
• Ability to make decisions that are timely and effective for achieving results consistent with business goals and organizational culture
• Possess motivational interviewing skills
• Possess excellent interpersonal communication skills
• Ability to speak clearly telephonically.
• Excellent critical thinking skills
• Works independently with minimal supervision
• Possess excellent computer skills including Microsoft applications
• Possess excellent time management skills
• Protect and take care of our company and member’s data every day by committing to work within our company ethics and policies
• Strong administrative/technical skills; Comfort working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), IM/video conferencing (Teams & Zoom), and telephones efficiently.
• Trustworthy and accountable behavior, capable of viewing and maintaining confidential information daily.

#LI- HW1 #LI Hybrid