Network Health's success is rooted in its mission to create healthy and strong Wisconsin communities. It drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking a Behavioral Health Care Manager. This individual will provide case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The care manager advocates for options and services to meet an individual's and family's comprehensive health needs through communication and coordination of available resources to promote quality, cost-effective outcomes.

**This position is eligible to work out of your home office in the state of Wisconsin. You must be able to travel to the Menasha (corporate) office as needed for meetings or training.**

Job Responsibilities:

• Screens candidates for case management and when appropriate completes assessments, care plans with prioritized goals, interventions, and timeframes for re-assessment using evidence-based clinical guidelines. Evaluates and determines member needs based on behavioral health clinical information such as diagnosis, disease progression, and other behavioral therapies.
• Reviews results from behavioral health tests and procedures and updates care plan to reflect progress towards goals; closes cases when expected goals/outcomes are achieved.
• Provides information and outreach regarding case or condition management activities to members, caregivers, providers and their administrative staff
• Evaluates and processes member referrals from physicians to other specialty providers
• Assess, plans, facilitates and advocates for individuals to identify quality, cost effective interventions services and resources to ensure health needs are met
• Works with members and families on self-management approaches using coaching techniques such as motivational interviewing
• Educates the individual, his/her family and caretakers about case and condition management, the individual's health condition(s), medications, provider and community resources and insurance benefits to support quality, cost effective health outcomes.
• Facilitates the coordination, communication and collaboration of the individual's care among his/her providers including tertiary, non-plan providers and community resources with the goal of controlling costs and improving quality.
• Schedules visits with the individual and participates in facility based care conferences as appropriate to ensure quality care, appropriate use of services, and transition planning.
• Stays abreast of current best practices and new developments
• Other duties as assign

Job Requirements:

• Master's degree in Social Work, or related field or Bachelor's degree in Nursing
• A minimum of four years' experience in behavioral health required
• Four years work experience as a social worker, Registered Nurse, or case manager
• Previous experience in case management, utilization management, insurance, or managed care preferred
• Experience with Medicare, Medicaid, preferred
• Current licensure in the State of Wisconsin as a Licensed Clinical Social Worker (LCSW) OR
• Current licensure in the State of Wisconsin as a Registered Nurse and a Psychiatric-Mental Health Nursing Certification (PMH-BC)
• Case Management certification preferred.
• Current and valid drivers license.

Network Health is an Equal Opportunity Employer. We encourage applications from all backgrounds, communities and industries, and are committed to having a team that is made up of diverse skills, experiences and abilities. We are committed to equality and diversity within Network Health.

*WARNING: Please beware of phishing scams that promote work-at-home opportunities and which may also pose as legitimate companies. Please be advised that Network Health recruiter will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for a role with our company. All of our positions require that you first complete an online application.