Team Lead QUEST Core BH Program, Social Work at Kapolei

Job Description

The Team Lead QUEST Core BH Program is responsible for overseeing and monitoring the day-to-day processes and staff of the Intensive Case Management (ICM) and Utilization Management components of the Core BH membership of the QUEST population.

 

The Team Lead will be a resource to team members and Plan case managers, providing support and assistance in application of Beacon’s level of care criteria, scheduling, answering questions about policies and procedures and being available to handle and train staff on difficult calls. The Team Lead, in conjunction with the Clinical Manager and Program Director, will identify training needs for other staff members, assist the clinical department in reaching contractual goals, performance objectives and support the organizational goals of customer service, efficient utilization management, organizational competency and value added case management.

Responsibilities

• Quality oversight of completed assessments and care planning, including determination of level of care decision making.
• Maintain caseload of lower-level of care members to ensure care needs are met and provide members with referrals and resources.
• Conduct telephonic assessment and develop an individual care plan with interventions based on bio-psychosocial assessment/care plan outcome.
• Assist and collaborate regarding interventions and identified barriers to treatment.
• Consults with physicians, mental health providers and other community service programs to facilitate care coordination.
• Re-evaluate intervention outcomes and make recommendation for modified or updated strategies to achieve care plan goals.
• Work collaboratively with counterparts on member outreach, engagement and program materials.
• Participate in development of product design and modification of workflows and program materials.
• Ensure members are being seen as per required acuity standards.
• Ensure program guidelines are followed and timeliness criteria are met.
• Assume other duties/projects as assigned.

Job Requirements

General Competencies

Works under minimal supervision and relies on significant experience and the exercise of judgment in the application of knowledge to the solution of difficult tasks. Consults with Supervisor and Manager on the more difficult and complex cases.

Skills

A minimum of 3-5 years combined direct behavioral health, supervisory and/or managed care experience required. Leadership skills and supervisory experience, including the ability to develop team performance.

Excellent written and oral communication skills. Self-motivated, able to prioritize multiple issues, excellent organizational skills, ability to track multiple projects/tasks and follow through as needed. Advanced level of PC skills required.

Country: USA, State: Hawaii, City: Kapolei, Company: Beacon Health Strategies.