The future is full of possibilities. At Banner Health, we’re excited about what the future holds for health care. That’s why we’re changing the industry to make the experience the best it can be. Our team has come together with the common goal: Make health care easier, so life can be better. The future of health care starts here. If you’re ready to change lives, we want to hear from you.
As a Health Plan Associate Behavioral Care Manager, there are exciting opportunities to be a part of the health care transformation. We are known nationally as an innovative leader in new health care models, where insurance plans and physicians come together to work collaboratively to make things easier for the member. The division serves over 500,000 members in our community.
Join a team where you will be conducting care management activities, participating in meetings with providers and the Behavioral Health Department, while being an advocate for our members. There may be special projects related to the implementation of the Arizona Complete Care Health Plan, that will be focusing on the integration of physical health, behavioral health, and social determinants.
Banner Health Corporate-Mesa
525 W. Brown RD
Mesa, AZ 85201
2701 E. Elvira
Tucson, AZ 85756
Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.
About University Physicians Health Plans
The University of Arizona Health Plans (UAHP) manage a variety of health plans. Our mission is to advance health and wellness through education, research and patient care.
About Banner Health
Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.
This position provides comprehensive care coordination for members/patients as assigned. This position assesses the members/patients plan of care needs, and develops, implements, monitors and documents the utilization of resources and progress of the member/patient through their care episodes, facilitating options and services to meet the members/patients health care needs. The intensity of care coordination provided is situational and appropriate based on member/patient need and payer requirements. This position is accountable for the quality of case management services delivered by both them and others and identifies/resolves barriers which may hinder effective member/patient care.
Manages individual members/patients across the health care continuum to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
Acts in a leadership function with process improvement activities for populations of patients/members to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
Evaluates the medical necessity and appropriateness of care, optimizing member/patient outcomes.
Establishes and promotes a collaborative relationship with physicians, payers, and other members of the health care team. Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements.
Acts in a leadership function to collaboratively develop and manage the High Need/High Cost Program and manage the interdisciplinary member/patient case staffing to ensure high levels of care coordination to promote improved health care outcomes or discharge plan. Effectively communicates the plan across the continuum of care.
Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts into daily practice.
Requires bachelors degree in social work or related field or equivalent experience.
Requires a proficiency level typically achieved with 5 years of clinical/case management experience and knowledge of Medicare and Medicaid Programs. Must have a working knowledge of care management, hospital and community resources. Must demonstrate critical thinking skills, problem-solving abilities, effective communication skills, and time management skills. Must demonstrate ability to work effectively in an interdisciplinary team format.
Additional related education and/or experience preferred.