Behavioral Health Case Management Specialist

Position Summary

The BH Case Management Specialist will utilize skills to achieve client wellness and autonomy through advocacy, communication, education, identification of service resources and service facilitation. The specialist will maintain a caseload of patients referred from AHL BH providers, make and monitor appropriate referrals, and help identify internal and external providers and facilities throughout the continuum of services. This role works closely with the BH Transitional Care specialist for patients moving from hospitalization or the ED into ongoing care at AHL, employing an integrative care model between Primary Care and Behavioral Health to assess, plan, facilitate, and coordinate care.

Minimum Qualifications

• Education: Master’s degree from an accredited school of social work, psychology, substance use, or a related human services profession.
• Experience: Three or more years of experience working in behavioral health.

Knowledge, Skills, and Abilities

• Understanding and proven experience in health management: prevention, screening, behavior modification, and mental health and substance misuse care modalities.
• Demonstrated ability to work effectively with clients via phone.
• Experience within a health‑care/managed‑care setting (preferred).
• Proficiency in Microsoft Office applications (Word, Outlook, Excel).
• Excellent verbal and written communication skills.
• Bilingual ability (a plus).
• Ability to work collaboratively and independently, establishing priorities.
• Ability to maintain the integrity of confidential information.
• Ability to support, encourage, and inspire clients through coaching during transitional periods of care.
• Strong listening skills—both spoken and unspoken—and appropriate response.
• Capability to de‑escalate and manage crises calmly, knowing when to engage emergency response.
• Use of tact and diplomacy; calm management of frustrated patients.
• Knowledge of customer service principles and practices.
• Knowledge of HIPAA laws related to mental health and substance misuse treatment.
• Ability to communicate with insurers about requirements/coverage and determine appointment appropriateness for BH patients.
• Understanding of major mental illnesses, commonly prescribed medications, and treatment continuums.
• Understanding of substance use disorders, commonly prescribed medications, and treatment continuums.
• Ability to convey the importance of integrated care to promote primary care for BH patients.

Essential Duties and Responsibilities

Client Relations

• Achieve client satisfaction by greeting clients and proactively attending to their needs.
• Appropriately screen clients using designated tools.
• Respond to client requests in a timely and efficient manner.
• Maintain confidentiality on and off duty.
• Maintain contacts with payers and patients for processing follow‑up care.
• Provide substance‑abuse education to students, families, and community health‑care practitioners.

Assessment

• Perform initial consultations, follow‑up, and education relevant to the client’s care.
• Obtain histories and develop accurate, competent notes.
• Advocate for safe delivery of care and client well‑being.
• Document client care, changes in treatment, symptoms, interventions, and strategies.
• Consult with colleagues when information may assist service delivery.
• Empower clients and families about diagnoses.

Implementation

• Assist in obtaining referrals, prior authorizations, and other necessary information.
• Maintain knowledge of referral lists for additional supportive services.
• Provide ongoing supportive and case‑management functions aligned with service plans.
• Conduct face‑to‑face reviews with clients and relevant staff to assess progress and modify service plans as needed.

Evaluation

• Apply critical thinking to identify cause‑and‑effect relationships in clinical situations.
• Evaluate client status and response to treatment.
• Modify plan of care based on client outcomes.
• Determine continued need for care or referral to other providers.
• Develop appropriate treatment/service plans with clients.

Safety / Infection Control

• Follow job safety requirements.
• Report accidents or incidents within 8 hours by completing an incident report.

Physical and Mental Requirements

• Communicate with internal staff, patients, and external entities.
• Stand, sit, walk, and converse for most of the day.
• Occasionally lift, carry, push, pull, or move objects less than 10 pounds.
• Operate telephone, computer terminal, printer, fax, and copier while performing duties.
• OSHA Category III: Normal routine with no exposure to blood, body fluid, or tissue; not required to perform emergency care or first aid.

Customer Relations

• Treat guests, patients, physicians, and employees with care, courtesy, and respect.
• Respond quickly and appropriately to customer requests.
• Suggest ways to better meet customer needs.
• Answer the clinic communications system promptly and courteously.

Teamwork

• Work cooperatively within own department and across other areas.
• Accept additional responsibilities and help make others’ jobs easier.
• Respond quickly to requests for assistance.
• Interact with other departments on problem issues.
• Accept feedback from patients, visitors, clinic employees, physicians, and the public.

Continuous Improvements

• Continuously look for and suggest ways to improve processes.
• Complete assignments to achieve greatest benefit at acceptable cost.
• Implement improvements as appropriate.
• Demonstrate interest in personal growth by evaluating performance, recognizing abilities and limitations, seeking improvement opportunities, and participating in in‑service and continuing education.
• Attend departmental and clinic‑wide meetings.

Communications

• Keep appropriate people informed.
• Speak and write clearly, concisely, and appropriately for the audience.
• Listen carefully and communicate tactfully.
• Respect confidentiality and privacy both on and off duty.

Self‑Management

• Present a positive image of Access Health Louisiana.
• Carry out assignments with minimal direction.
• Maintain timeliness, confidentiality, and proper notification of absence or tardiness.
• Work weekends and shifts when necessary.