Autism Care Manager, BCBA

HealthPartners is hiring a Case Manager, Behavioral Health/Autism Care Manager. This role will specifically support the Autism Care Management team. Applicants are required to have Board Certified Behavioral Analyst (BCBA) certification and experience working with individual with Autism Spectrum Disorder. The position exists to provide support to patients, their families, and physicians in addressing behavioral health and social concerns; educate and empower patients and families to make informed personal health care decisions; and facilitate communication between patient, physician, health plan and community.

ACCOUNTABILITIES:

Member Focus

1. Ensures all activities are member-focused and individualized, resulting in personalized attention to each patient's unique needs.
2. Identifies interventions and resources to assist member reaching personal health related goals.
3. Identifies patterns and episodes of care that are predictive of future needs and services.

Integration

1. Integrates clinical and psychosocial information for case identification and individual patient assessment to develop action-oriented and time-specific planning and implementation of appropriate interventions.
2. Facilitates integration of patient care by encouragement of effective communications between patients, families, providers, health plan and care system programs, and community-based services.
3. Adheres to policy and procedure in daily activities.
4. Coordinates service coverage with appropriate funding sources when indicated.

Communication

1. Effectively and routinely communicates with patients, families, physicians and health care team members to facilitate successful collaboration resulting in high levels of member/patient/family/provider satisfaction.
2. Provides regular reporting of member outcomes to behavioral health leadership according to defined process.
3. Identifies and promptly reports potentially adverse situations to department leadership.
4. Identifies and promptly reports high cost cases for reinsurance.
5. Maintains confidentiality of information in accordance with department and corporate policies.

Relationships and Team Building

1. Establishes and maintains good working relationships within the Behavioral Health Improvement and Operations Department, with other HealthPartners Departments, and with other health team participants.
2. Supports other team members in achieving patient centered goals.
3. Assists supervisor in maintaining a cohesive team by contributing to a collaborative, respectful, and diverse environment.
4. Participates in and contributes to appropriate departmental and/or organizational meetings.
5. Acts as a liaison between internal customers, Marketing, Sales, Claims and Member Services to resolve systems/process issues.

Technology

1. Maintains knowledge of and effectively uses automated applications and systems.
2. Identifies deficits in technological literacy and seeks appropriate training under guidance of supervisor.
3. Maintains maximum individual productivity through proficient use of automated systems.

Personal Development

1. Participates in ongoing independent study and education-related professional activities to maintain and increase knowledge in the areas of case management, patient care services, and benefit packages for development of effective case management skills.
2. Demonstrates responsiveness to and appreciation of constructive feedback and recommendations for personal growth and development.
3. Maintains current, active Minnesota licensure.

Other Duties

1. Willingly participates in various committees, task forces, projects, and quality improvement teams, as needed and assigned.
2. Performs other duties as assigned.

Required Qualifications

* Licensed in Minnesota as LICSW, or RN, or Psychologist, Masters degree preferred.
* Board Certified Behavior Analyst (BCBA) certification
* Experience working with individuals with Autism Spectrum Disorder
* Minimum of three (3) years of clinical practice experience
* Minimum of three (3) years of relevant utilization review, discharge planning, case management, or care coordination experience
* Current clinical knowledge and demonstrated sound clinical judgment
* Demonstrated ability to collaborate effectively with interdisciplinary care team members, including strong written, verbal, and interpersonal communication skills
* Demonstrated working knowledge of quality improvement, utilization management, benefit plan fiscal management, and various healthcare payment methodologies
* Working knowledge of healthcare delivery systems, including managed care or HMO environments preferred
* Demonstrated proficiency using automated medical management or electronic health record systems
* Demonstrated flexibility, organization, and ability to make sound decisions in complex or rapidly changing situations
* Ability to organize, prioritize, and manage multiple responsibilities simultaneously
* Ability to effectively navigate change and ambiguity

Preferred Qualifications

* Licensed Behavior Analyst (LBA) or Licensed Psychologist (LP) with BCBA certification
* Master's degree in a related clinical or behavioral health field

Additional Acceptable Licensure (With Autism Experience)

Candidates may also be considered if they hold one of the following licensures and have direct experience supporting individuals with Autism Spectrum Disorder:

* Licensed Professional Clinical Counselor (LPCC)
* Licensed Marriage and Family Therapist (LMFT)

DECISION-MAKING:

1. Makes independent decisions within the scope of this position's accountabilities and determines the need for and the timing of consultation with behavioral health leadership.
2. Uses sound judgement, organizational knowledge, industry knowledge, and common sense in determining appropriate alternatives for members/patients/families, consulting with leadership and/or Medical Director, when indicated.
3. Utilizes the member contract coverage policy on-line benefits, level of care guidelines and Member or Claims Services on-line policies and procedures.
4. Makes recommendations to leadership regarding policy development needs and/or changes.

MAJOR CHALLENGES:

1. Maintaining member focus in a rapidly evolving environment.
2. Influencing team members and colleagues to work collaboratively in achieving the goals and objectives of the department.
3. Maintaining timely, comprehensive reviews with concise documentation of pertinent facts, decisions and rationale.
4. Maintaining appropriate use of supervisory and consultation resources