BH Case Manager – Federal Employee Program

Responsibilities

• Supporting utilization management functions for more complex and non‑routine cases as needed.
• Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs.
• Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits.
• Performing the essential activities of case management: assessment, planning, implementation, coordinating, monitoring, outcomes and evaluation.
• Perform case management activities in community settings including face to face with members as required.

Requirements

• Current, active unrestricted Tennessee license in Nursing (RN) or behavioral health field (Master's level or above) required.
• 3 years - Clinical behavioral health / substance use disorder experience required.
• 1 year - Must be knowledgeable about community care resources and levels of behavioral health care available.
• Experience with Motivational Interviewing Techniques and Adult Learning Styles.
• Currently has a Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire.
• Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint).

Hard Skills

• clinical behavioral health
• substance use disorder
• case management
• assessment
• planning
• implementation
• coordinating
• monitoring
• outcomes evaluation
• motivational interviewing

Soft Skills

• liaison
• communication
• coordination
• interpersonal skills
• organizational skills

Certifications & Qualifications

• Tennessee nursing license
• Certified Case Manager (CCM)

Industry Keywords

• utilization management
• community care resources
• behavioral health care
• health care delivery
• benefits programs

Tools & Technologies

• Microsoft Office
• Outlook
• Word
• Excel
• PowerPoint