Under the direction of the ALTCS Behavioral Health Senior Manager, the Behavioral Health Professional 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.
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.
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.
Provides consultation to case managers and all departments, including providing education and training to case manager and contract providers.
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.
Assists in the petitioning process for members who need court-ordered treatment (COT) and monitors the COT and the members compliance.
Reviews, approves, tracks, and monitors all BH reinsurance requests and supporting documentation to AHCCCS/Division of Health Care Management/ALTCS Unit using appropriate forms.
Generates reports, analyzes findings and prepares written reports addressing strengths and areas for improvement regarding behavioral health services.
Establishes and maintains working relationships with contracted providers and community health agencies.
Requires a Masters 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.
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.Valid and unrestricted Arizona drivers license required.
Reliable vehicle with an appropriate auto insurance and ability to speak Spanish is preferred.
Additional related education and/or experience preferred.
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