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Behavioral Health After Care Follow Up Clinician

Job Ref: 60739
Category: Utilization Review and Case Management
Department: BEHAVIORAL HEALTH HARP
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $78,000.00
Salary Range: $78,000.00 - $83,000.00

About NYC Health + Hospitals

MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life. 

Position Overview

The Behavioral Health After Care Follow Up Clinician is responsible for scheduling aftercare follow-up for members discharging from an acute behavioral health inpatient setting. The Behavioral Health After Care Follow Up Clinician ensures that members have a scheduled appointment in place, completes follow-up and reminder call to member and follows up with providers to ensure member’s compliance with aftercare. This role works closely with CORE and HARP BH Case Managers as well as BH Utilization Management Clinicians and Hospital Discharge Planners to assure compliance with HEDIS measures for follow-up after hospitalization. 

Interviewing now, 6 positions available: 2 with start date in Q3 2021, 3 with start date in Q4 2021 and 1 with start date in Q1 2022

Job Description

  • Assists members and providers in accessing post-discharge aftercare related appointments. Works with inpatient facility team to identify appropriate follow-up care for CORE and HARP BH members. 
  • Interfaces with members, hospital staff, providers, and provider office staff to coordinate aftercare for members. Verifies and updates eligibility information as needed.
  • Identifies barriers to discharge planning and works collaboratively with both MP UM and CM BH staff plus inpatient facility to remove identified barriers.
  • Provides education to inpatient staff to promote effective Discharge Planning for the CORE and HARP BH membership. 
  • Provides regular telephonic support to treatment providers and assists with questions/concerns about treatment follow-up options.
  • Engages in on-site training(s) with facility/Hospital staff to increase knowledge of aftercare trends and options for follow-up for the BH HARP and CORE membership.
  • Responsible for outreaching members regarding adhering to 7-day follow up appointment to offer a 30-day appointment as part of HEDIS measures.
  • Responsible for mailing discharge aftercare letters with a list of referrals to members not reached by phone.
  • Performs other appropriate Behavioral Health duties and participates in other special projects as assigned, including, but not limited to, monthly audit review and preparation, quality improvement, community health education and facility/provider relations as related to member Aftercare activities.

Minimum Qualifications

  • Minimum 3 years of Behavioral Health (Serious Mental Illness & Substance Use Disorder) experience in managed care utilization review, quality assurance, discharge planning. (Experience working in a Psychiatric Hospital Inpatient and/or Outpatient setting preferred)
  • Previous Experience within the HARP BH Population a plus.
  • Pharmacy, Psyckes, E-Paces, HCS (UAS) MAPP knowledge
  • Bilingual preferred
  • Strong interpersonal skills, the ability to remain calm and poised with challenging providers
  • Familiarity with the fast-paced type of working environment
  • Previous Quality Management liaison experience with hospitals and other large-volume providers to address cost. as well as HEDIS/QARR quality performance, preferred. 
  • Exceptional Organizational and Communication Skills.

Licensure and/or Certification Required

  • LCSW, LMSW, LMHC, RN.  Current valid unrestricted NY State License.

Professional Competencies

  • Integrity and Trust
  • Teamwork and Problem-Solving Attitude
  • Customer Service
  • Superior Technical Computer skills (Microsoft Office, DCMS, Care Connect, Teams Video Application) 
  • Clear and Concise Written/Oral Communications