Job Overview
Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to DE&I combines a focus on our people processes and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area’s top companies in volunteering & giving, and one of the world’s most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in – join us!
Your Role
Reporting to the Behavioral Health team manager, the BSC behavioral health care manager helps members with behavioral health needs navigate the health care system for linkages to BH providers, treatment, and program. The BH care manager will offer support in assessing member’s emotional and psychological well-being and providing resource coordination, crisis intervention, substance abuse, and with any behavioral or mental health referrals.
The BH care manager will be available to physicians and nurse care managers as a consultant for patients with complex psychosocial needs. The position demands for an intensive focus on crisis intervention and counseling, problem-solving and conflict resolution, patient and family management, interdisciplinary collaboration, psychosocial assessments, education, advocacy, and community resource linkages
Your Work
In this role, you will:
- Collaborate with case managers and other team members to complete member assessments related to social and resource needs to support member access to services
- Collaborate with service coordination staff and act as liaison to ensure timely and accurate response to customer need
- Collaborate with providers to support members treatment plan and care needs
- Recognize the clients right to self-determination as it relates to the ethical principle of autonomy, including the client/family’s right to make informed choices that may not promote the best outcomes, as determined by the healthcare team
- Assess members health behaviors, cultural influences and clients belief/value system and evaluates all information related to current/proposed treatment plan and in accordance with clinical practice guidelines to identify potential barriers
- Efficiently manages and maintains a caseload of members for BH care coordination and or BH case management for persons experiencing severe and persistent mental illness
- Maintains an active workload in accordance with National Care Manager performance standards
- Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria
- Interacts with utilization department and Physician Advisors to discuss clinical questions and concerns regarding specific cases
- Coordinates services with state and community programs on behalf of the member, particularly when the member is unable to effectivley do so independently
- Conducts field visits in settings such as, but not limited to, hospitals, skilled nursing facilities, assisted living facilities, shelters, sober living homes, and private residences to complete assessments and provide psychosocial interventions.
- Engages members, and/or members’ support system, in planning safe discharges and transitions between settings
- As a mandated reporter, files and follows up on reports made to the appropriate government agency(e.g., Adult Protective Services, Child Protective Services, etc.)
- Actively participates in interdisciplinary team meetings and case consultations with licensed manager
Your Knowledge and Experience
- Requires a master’s or doctorate degree in Social Work, Marriage, family, and child counseling, Marriage and family therapy, Couple and family therapy, Psychology, Clinical psychology, Counseling psychology, Counseling or clinical mental health counseling with an emphasis in either marriage, family, and child counseling or marriage and family therapy. LCSW, LMFT, LPCC, PSYD by Board of Behavioral Sciences required
- Requires at least 5 years of prior relevant experience including 3 years of experience working with the Medi-Cal population, medical social work, community clinics, or other home and community-based organizations
- Experience conducting thorough psychosocial assessments, developing care plans, and providing necessary interventions identified during assessment with complex client populations that may have, among other things, inadequate coping skills, severe emotional disorders, developmental disabilities, mental illnesses, and/or unstable housing
- Thorough knowledge of services provided by, and eligibility for, applicable state and federal programs, including Long Term Services and Supports (LTSS), in addition to local, community-based organizations. Knowledge of all levels of care available for this population
- Considerable knowledge of a wide range of psychosocial chalenges and familiarity with behavioral health diagnosis and treatment
- Comprehensive knowledge of specific case management, discharge planning, utilization management, disease management and community resources
- Able to operate PC-based software programs including proficiency in Word, Excel and Outlook. Ability to manage several software programs
- Strong communication, abstracting skills with strong verbal and written communication skills
Our Values
- Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we’re going to do and by acknowledging and correcting where we fall short.
- Human. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
