Behavioral Health Clinician (Board Certified Behavioral Analyst)
Company: Horizon Blue Cross Blue Shield of New Jersey
Posted on: October 13, 2019
Job Summary:This position is responsible for performing behavioral
health duties using established guidelines to ensure appropriate
level of care as well as planning for the transition to the
continuum of care. Performs duties and types of care management as
assigned by management.
* Assesses patient's behavioral health clinical need against
established guidelines and/or standards to ensure that the level of
care and length of stay of the patient are medically appropriate
for inpatient stay.
* Evaluates the necessity, appropriateness and efficiency of
behavioral health medical services and procedures provided.
* Coordinates and assists in implementation of plan for
* Monitors and coordinates services rendered outside of the
network, as well as outside the local area, and coordinates
internally for negotiation of fees for such services as
appropriate. Coordinates with patient, family, physician, hospital
and other external customers with respect to the appropriateness of
care from diagnosis to outcome.
* Coordinates the delivery of high quality, cost-effective care
supported by clinical practice guidelines established by the plan
addressing the entire continuum of care.
* Monitors patient's behavioral health medical care activities,
regardless of the site of service, and outcomes for appropriateness
* Advocates for the member/family among various sites to coordinate
resource utilization and evaluation of services provided.
* Encourages member participation and compliance in the behavioral
health case/disease management program efforts.
* Documents accurately and comprehensively based on the standards
of practice and current organization policies.
* Interacts and communicates with multidisciplinary teams either
telephonically and/or in person striving for continuity and
efficiency as the member is managed along the continuum of
* Understands fiscal accountability and its impact on the
utilization of resources, proceeding to self-care outcomes.
* Evaluates care by problem solving, analyzing variances and
participating in the quality improvement program to enhance member
* Completes other assigned functions as requested by
* Requires a masters in a behavioral health related field or
* Requires a minimum of two (2) years behavioral health clinical
* Behavioral health experience, preferably in a managed care
setting, strongly preferred.
ADDITIONAL LICENSING, CERTIFICATIONS, REGISTRATIONS:
* Active Unrestricted NJ LCSW, LMFT, LPC, RN License or Applied
Behavior Analysis Certification Required
* Applied Behavior Analysist Certification preferred
* Prefers proficiency in the use of personal computers and
supporting software in a Windows based environment, including MS
Office products (Word, Excel, PowerPoint) and Lotus Notes; prefers
knowledge in the use of intranet and internet applications.
* Prefers working knowledge of case/care management principles.
* Prefers working knowledge of principles of utilization
* Prefers basic knowledge of health care contracts and benefit
* Prefers knowledge of hospital structures and payment systems.
SKILLS AND ABILITIES:
* Interpersonal & Client Relationship Skills
* Planning/Priority Setting
* Problem Solving
* Team Player
* Time Management
* Written/Oral Communication & Organizational Skills
TRAVEL % (IF APPLICABLE):
* For field based positions, travel required 100%.
HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY IS AN EQUAL
OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER. ALL QUALIFIED APPLICANTS
WILL RECEIVE CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO RACE,
COLOR, RELIGION, SEX, NATIONAL ORIGIN, SEXUAL ORIENTATION, GENDER
IDENTITY, PROTECTED VETERAN STATUS OR STATUS AS AN INDIVIDUAL WITH
A DISABILITY AND ANY OTHER PROTECTED CLASS AS REQUIRED BY FEDERAL,
STATE OR LOCAL LAW.
Keywords: Horizon Blue Cross Blue Shield of New Jersey, Newark , Behavioral Health Clinician (Board Certified Behavioral Analyst), Professions , Newark, New Jersey
Didn't find what you're looking for? Search again!