Behavioral Health Navigator

Santa Barbara, CA, United States

Job Details

Job Location

Main Office - Santa Barbara, CA

Position Type

Full Time

Education Level

Bachelor's Degree

Travel Percentage

None

Job Category

Behavioral Health

Description

California Payrate range: $32.35 - $46.91 per hour

Job Summary

This position will assist with the coordination of care issues. The Behavioral Health Navigator will help members access Behavioral Health services promptly, provide:

Coaching related to psychoeducation of mental health symptoms.

The importance of treatment plan compliance.

Utilization of appropriate mental health resources.

Appropriate use of CenCal mental health or behavioral health treatment benefits.

Use of other community resources.

This position will initially support the Behavioral Health Department, receiving Member follow-up tasks from teams and the Call Center. Depending on task volume, it may be assigned to primarily support a specific team or call center.

Duties and Responsibilities Assesses members' needs and develops plans to support members' access to care through appointment scheduling, education, and care coordination with primary care physicians, mental health practitioners, county providers, and community-based organizations.

Maintains ongoing health records by state, organizational, and NCQA regulations and in keeping with accepted community standards.

Utilizes resources of public and private agencies and community organizations to meet the members' needs.

Provides appropriate support to members and their families, including explanation of treatment and benefits, instructions on how to support treatment, and interventions to increase acceptance of and adherence to treatment.

Ensures care coordination, patient education, and information and referrals based on member's assessment of needs, member's request, or policy and procedure.

Engages collaboratively with community-based and government agencies to assure continuity and coordination of care for your patients

Participates in data collection and management.

Demonstrates ability to manage multiple member referrals while maintaining daily productivity of all requests assigned.

Participates in consultation, peer review, team activities, and meetings.

Coordinate appropriate member assistance for scheduling appointments for mental health services and other tasks as Behavioral Health Department staff requested.

Coordinate document efforts in appropriate systems and with referring providers and other departments, such as Case Management, within expected time frames.

Adhere to all CenCal Health Policies and Procedures and meet required performance standards.

Works collaboratively with internal and external teams.

Ensures compliance with Medi-Cal requirements for timely access to care, turnaround time, and other organizational policies and procedures.

As requested, participate in the audit, audit readiness, and other related organizational activities.

Supports organizational and departmental strategic planning initiatives and goals.

Ensures coverage of the behavioral health call center as assigned.

Other duties and responsibilities as assigned.

Qualifications

Knowledge/Skills/Abilities

Required: Knowledge and experience in mental health services to Medi-Cal and county systems of care.

Effective problem solver who uses sound judgment and quickly identifies and understands issues, problems, and opportunities; uses case management principles, best practices, and data to evaluate alternatives and recommend solutions.

Ability to be attentive to the diverse needs of each client and secure relevant client care data to identify key issues in managing care while simultaneously managing high-volume client cases.

Preferred: Bilingual

Knowledge of Medi-Cal eligibility-related issues, DSS, SSA, TCRC inter-workings, and an understanding of the State's beneficiary assignment and processes related to the Plan.

Must demonstrate complete knowledge and understanding and possess a high level of skill set and proficiency with Microsoft Office Suite, including Outlook, Word, and Excel

Coordination skills relating to Care Management requests and understanding fundamental principles and practices for appropriate hand-offs and follow-through with clinical teams.

Excellent and effective oral and written communication skills, including member coaching and strong interpersonal skills.

Must demonstrate, upon completion of orientation and training modules, a thorough understanding of CenCal's various healthcare program benefits and applicable co-payments, eligibility, coordination with the local government and CBO agencies, pharmacy formulary, and provider network.

Must possess a positive attitude and contribute to the success of the department and team.

Strong ability to work effectively under pressure and independently with minimal supervision.

Ability to manage multiple priorities and assume special projects over and above assigned responsibilities.

Education and Experience Undergraduate degree in psychology, social work, or counseling, or four (4) years' experience in a managed care environment working with the underserved, mentally ill, working poor population, persons with disabilities, and home health department, behavioral health, or developmental disability setting.

Experience with case management, care coordination, or coordinating patient needs in a medical setting.

Experience using solution-based strategies to support members/patients.