The Behavioral Health RN Care Manager position is involved with member management through participation in processes of assessment, planning, implementation, coordination, and evaluation of patient behavioral health care delivery. The position performs care management, care coordination, and utilization review of behavioral health treatment for all levels of outpatient and inpatient services for Priority Health members. This position directs and manages initial and on-going intensive psychiatric and substance use disorder treatment services through clinical triage and utilization management activities. Position activities range from providing telephonic member education and evaluation, to functioning as liaison between the member and providers to promote the highest quality of care in the most appropriate setting in the most cost -effective manner. Additional range of functions include; providing patient care on the unit and emergency service referrals, contact with providers and members regarding benefits, care coordination, authorization and treatment, participation in complex case review, care management meetings, and other tasks as assigned by the unit manager.

• Assesses internal and external referrals to identify patient/significant others’ needs, level of intensity, insurance benefits and other patient resources.
• Develops plan of care and makes recommendations to PCPs, specialists and other members of the health care team regarding care management strategies, identifying strategies to maximize continuity of care across the continuum.
• Assesses the educational needs of patients, families and members of the health care team and develops and implements appropriate teaching strategies or makes appropriate referrals.
• Communicates and collaborates with patient/significant others/providers/payers to coordinate services that improve access to appropriate services across the continuum of care and which promotes optimal health in a cost-effective manner.
• Measures patient care outcomes, interprets reports and analyzes data trends for groups of patients.
• Documents patient data, plan, interventions and outcomes according to department guidelines.

• Required Bachelor's Degree or equivalent nursing or a healthcare related field

• 5 years of relevant experience clinical nursing and or case management/managed care or related field Required

• LIC-Registered Nurse (RN) - STATE_MI State of Michigan Upon Hire required
• CRT-Case Manager, Certified (CCM) - CCMC Commission for Case Manager Certification Upon Hire preferred

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CURRENT SPECTRUM HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Spectrum Health team members only.

Spectrum Health is committed to providing a safe environment for our team members, patients, visitors and community. That is why we require a drug-free workplace and various vaccinations as a requirement for employment.

Spectrum Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, sexual orientation, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

If you are a qualified individual with a disability, you may request assistance in completing the application process by calling 616.486.7447. We are committed to granting reasonable accommodations in accordance with applicable laws.