Primary City/State:

Arizona, Arizona

Department Name:

ALTCS CM

Work Shift:

Day

Job Category:

Clinical Care

The future is full of possibilities. At Banner Plans & Networks, we’re changing the industry to reduce healthcare costs while keeping members in optimal health. If you’re ready to change lives, we want to hear from you.

Banner Plans & Networks (BPN) is an integrated network for Medicare and private health plans. Known nationally as an innovative leader, BPN insurance plans and physicians work collaboratively to keep members in optimal health while reducing costs. Supporting our members and vast network of providers is a team of professionals known for innovation, collaboration, and teamwork. If you would like to contribute to this leading-edge work, we invite you to bring your experience and skills to BPN.

 As a Behavioral Health Professional for Arizona Long Term Care Services, ALTCS, you will be ensuring that members with behavioral health conditions receive the care they need while complying with AHCCCS regulations. Your experience and leadership will be crucial for providing comprehensive care and support to members, ensuring they receive integrated and effective treatment.

Your work week will be primarily Monday-Friday working in Arizona business hours. There may be after hours call required for this role. This role does require Arizona Residency for compliance.

Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY
This position is responsible for providing the administrative and clinical oversight for ALTCS members with behavioral health conditions, ensuring compliance with all AHCCCS regulations. This includes coordinating services for members who are dually diagnosed with both a physical disability and mental illness, including substance abuse, developing processes to coordinate behavioral health care between primary care providers and behavioral health providers and producing required quarterly reports in consultation with case managers.

CORE FUNCTIONS
1. Coordinates member behavioral care needs with Case Managers, behavioral health providers, Primary Care Providers and ensuring medically necessary services, to include assisting case managers to develop behavioral health service plans while tracking and monitoring service plans for members who receive BH services.

2. Receives quarterly reports from case managers regarding the status and progress of members receiving behavioral health services and ensures the reports are sent to PCPs.

3. Provides consultation to case managers and all departments, including providing education and training to case manager and contract providers.

4. Develops processes to coordinate behavioral health care between primary care providers and behavioral health providers, to include participating in the identification of best practices for behavioral health services.

5. Assists in the petitioning process for members who need court-ordered treatment (COT) and monitors the COT and the members’ compliance.

6. Reviews, approves, tracks, and monitors all BH reinsurance requests and supporting documentation to AHCCCS/Division of Health Care Management/ALTCS Unit using appropriate forms.

7. Generates reports, analyzes findings and prepares written reports addressing strengths and areas for improvement regarding behavioral health services.

8. Establishes and maintains working relationships with contracted providers and community health agencies.

9. Facility based while remaining within budgetary allowances. Internal customers: all levels of nursing management and staff, medical staff, and all other members of the interdisciplinary healthcare team. External customers: physicians, payers, community agencies, provider networks and regulatory agencies.

MINIMUM QUALIFICATIONS

Requires a Master’s Degree in Social Work, Phycology, Gerontology, Counseling or related field.

Valid Arizona Licensed Psychologist, or a Behavioral Health Medical Practitioner, Licensed Master Social Worker, Licensed Counselor, Licensed Marriage and Family Therapist or Licensed Substance Abuse Counselor. Valid and unrestricted Arizona driver’s license required.

Requires a proficiency level typically achieved with 3 years of experience in a behavioral health setting. treatment modalities, interventions and techniques; of different types of assessments and their uses in treatment planning; of members’ rights; of local community resources and service delivery systems such as housing, social, welfare, educational, etc.

Good computer skills and the flexibility to learn different computer systems.

PREFERRED QUALIFICATIONS

Reliable vehicle with an appropriate auto insurance and ability to speak Spanish is preferred.

Additional related education and/or experience preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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