About Fallon Health:
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.
Fallon Health is a leader in providing senior care solutions such as NaviCare, a Medicare Advantage Special Needs Plan and Senior Care Options program. Navicare integrates care for adults age 65 and older who are dually eligible for both Medicare and MassHealth Standard. A personalized primary care team manages and coordinates the NaviCare member’s health care by working with each member, the member’s family and health care providers to ensure the best possible outcomes.
The NaviCare Behavioral Health Manager is responsible for:
Program Leadership Activities:
Provider/Vendor Management and Coordination:
Program Oversight (as assigned):
Member Related Oversight (as assigned):
Education: Graduate from an accredited school of social/behavioral health mandatory. Advanced degree in social work/mental health field required
License: Active, unrestricted license as a Licensed Mental Health Clinician; OR Licensed Mental Health Family Therapist,; OR Licensed Independent Clinical Social Worker; AND current Driver’s license
Certification: Certification in Case Management a plus
Resources: Microsoft products (Word, Excel, Visio, Powerpoint, Outlook); reporting software such as Business Objects; Boxer Application; CaseNET TruCare System; QNXT System
Other: Satisfactory Criminal Offender Record Information (CORI) results required
Physical Requirements of Role:
Usual office environment with frequent sitting, walking, standing, and occasional climbing, stooping, kneeling, crawling and balancing. Frequent use of eye, hand and finger coordination enabling the use of office machinery. Oral and auditory capacity enabling interpersonal communication as well as communication through automated devices such as the telephone. Activity is frequent, at least 2/3 of the time.
In addition, this role requires independent driving capability and the ability to perform in home visits to members and/or providers/facilities. Activity is occasional – activity exists less than 1/3 of the time.