Clinical Case Manager, Behavioral Health

About the role

The Clinical Case Manager Behavioral Health (CM-BH) facilitates appropriate member physical and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services.

Responsibilities

• Conduct comprehensive assessments of referred member's needs/eligibility and determine approach to case resolution.
• Evaluate member's benefit plan and available internal and external programs/services.
• Apply clinical judgment to incorporate strategies to reduce risk factors and address complex clinical indicators.
• Perform crisis intervention with members experiencing a behavioral health or medical crisis and refer them to appropriate clinical providers.
• Provide crisis follow-up to members to ensure they are receiving appropriate treatment/services.
• Enhance medical appropriateness and quality of care by applying and interpreting applicable criteria and clinical guidelines.
• Consult with supervisors, Medical Directors, and other programs to overcome barriers to meeting goals and objectives; present cases at case conferences to achieve optimal outcomes.
• Identify and escalate quality of care issues through established channels.
• Utilize motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes.
• Coach, inform, and support members to make ongoing independent medical and/or healthy lifestyle choices.
• Help members actively and knowledgeably participate in healthcare decision-making.
• Analyze utilization, self-report, and clinical data to identify comprehensive member needs.
• Multitask, prioritize, and adapt to a fast-paced changing environment.
• Communicate effectively, both verbally and in writing.

Requirements

• Reside in Louisiana.
• Have reliable transportation and the ability to travel in-state up to 50% of the time.
• Hold an unencumbered Independent Behavioral Health Clinical license in Louisiana (e.g., LCSW, LPC, LMFT).
• Have 3+ years of direct clinical practice experience post master’s degree, with general youth or pediatrics population in a hospital setting, alternative care setting such as ambulatory care, residential, or outpatient clinic/facility.
• Have 2+ years of experience with personal computers, keyboards, and MS Office Suite applications.

Preferred Qualifications

• Be certified as a Case Manager (ACM).
• Have crisis intervention skills.
• Have experience with child welfare and/or juvenile justice.
• Have managed care/utilization review experience.
• Have case management and discharge planning experience.

Qualifications

• Master’s degree required.
• Specialized training or relevant professional qualifications.

Benefits

This full-time position is eligible for a comprehensive benefits package including medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.