Pop Health Behavioral Healthcare Coordinator
$70,000–$85,000 year
HybridSunrise, Florida, United States
Sunrise, Florida, United StatesHybridFull Time$70,000–$85,000 yearMedium
Full TimeMedium
Job Summary
Coordinate care for enrollees with severe mental illness by conducting comprehensive needs assessments, developing individualized care plans, and managing services for medical, behavioral, and substance use needs. Lead a multidisciplinary team to identify high-risk clients, address care gaps, and facilitate discharge planning for hospitalized members while reducing avoidable emergency room visits. Deliver brief behavioral interventions using evidence-based techniques such as motivational interviewing and conduct in-home assessments to evaluate safety and resource availability. Collaborate with providers and medical directors to optimize resource utilization, ensure compliance with Medicaid and PCMH standards, and empower members to self-manage chronic conditions.
Required Qualifications
- Bachelor's Degree in social work and/or Nursing
- 3-5 years of clinical experience
- 3-5 years of experience in a managed care, health plan, or insurance setting, particularly in behavioral health or disease/case management roles
- Experience coordinating care across medical, behavioral, and social service providers, including familiarity with utilization management processes, appeals, and authorizations
- Experience working with Medicaid, Medicare, or other state and federal health care programs, including knowledge of relevant regulations and compliance requirements
- Knowledge of Microsoft Office and internet software
- Exceptional Interpersonal Communication Skills: Demonstrated ability to collaborate and communicate effectively in a team setting, with a focus on building and maintaining professional relationships with enrollees and other members of the care team
- Excellent oral and written communication skills, with strong problem-solving abilities
- Ability to self-motivate and work independently with minimal supervision, demonstrating strong organizational, problem-solving, and decision-making skills
- Strong analytical skills and problem-solving ability, with a focus on reviewing clinical information, assessing needs, and developing tailored care plans to improve member outcomes
- Proficiency in screening for common mental health and/or substance use disorders, conducting assessments, and developing treatment plans
- Working knowledge of differential diagnosis, evidence-based psychosocial treatments, and brief behavioral interventions, such as motivational interviewing, problem-solving treatment, and behavioral activation
- Understanding of psychopharmacology for common mental health disorders within the appropriate scope of practice, including the ability to educate and support enrollees regarding medication management and treatment adherence
- Ability to effectively engage enrollees in therapeutic relationships, both in person and via telephone, to promote adherence to care plans and encourage self-management of chronic conditions
- Experience in building and participating in cross-functional teams, with a strong ability to facilitate coordination, communication, and collaboration among care team members to achieve goals and maximize positive member outcomes
- Ability to follow projects or assignments through to successful completion, ensuring tasks are executed effectively and within established timelines
- Proficient in maintaining documentation that meets compliance with quality standards, organizational policies, and HIPAA guidelines, including accurate and timely record-keeping
- Ability to work effectively with diverse populations, understanding the cultural, linguistic, and socioeconomic factors that impact care delivery and engagement
- Experience using Electronic Health Records (EHR) and health plan-specific systems, such as care management platforms or claims processing systems, to coordinate care and track member progress
- Strong professional interaction skills with the ability to make sound decisions, handle complex situations, and maintain a high standard of professionalism in all member and provider interactions
Desired Qualifications
- Master's Degree in social work (MSW) or Nursing (Preferred)
- Psychiatric/Mental Health Nursing Certification (Preferred)
- Registered Nurse licensure in the state of Florida, or State Licensure in Social Work or related field (Preferred)
- Certified Case Manager (Preferred)
- License Clinical Social Work (LCSW), Licensed Mental Health Counselor (LMHC) – (A Plus)
- Psychiatric- Mental Health Nursing Certification (A Plus)
- Certified Addictions Registered Nurse (CARN) (A Plus)
- Knowledge of EPIC and/or JIVA (preferred)
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