Hybrid Behavioral Health (BH) Clinical Care Manager - Holyoke/Chicopee

This is a community-based behavioral health clinician role focused on integrating health services and community resources to coordinate care for dually eligible enrollees with complex medical, behavioral, and social needs in Massachusetts.

Responsibilities

• Engage with enrollees in their homes and other community settings to establish effective, complex care management relationships, considering cultural and linguistic needs.
• Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions.
• Perform required assessments on a timely basis, including Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments.
• Engage enrollees in care plan development and implementation, providing routine updates as the enrollee’s status changes.
• Lead the interdisciplinary care team (ICT) and collaborate with internal and external peers to create holistic care plans addressing medical and non-medical needs.
• Oversee enrollee utilization of long-term services and supports, ensuring systems are in place for enrollees to remain in their preferred location.
• Assist members in accessing community resources, including housing, transportation, food assistance, and social services.
• Educate members about their Medicare and Medicaid benefits and available services.
• Provide education to members and families about managing chronic conditions, medication adherence, and preventive care.
• Promote healthy lifestyle choices and self-management strategies.
• Assist enrollees in preventive health strategies, including gap closure.
• Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions.
• Coordinate care with primary care physicians, specialists, and other healthcare providers.
• Collaborate with community-based organizations, state agencies, and other service providers to avoid duplication of services.
• Advocate for the needs and preferences of enrollees within the healthcare system.
• Evaluate member satisfaction through open communication and monitoring of concerns or issues.
• Conduct regular travel for member, provider, and community-based visits as required.
• Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter.
• Adhere to NCQA and Care Management standards.
• Perform other job-related duties as requested.

Requirements

• Master’s degree in social work or mental health counseling and independent license required.
• Ability to independently serve people with complex medical, behavioral, and social needs.
• Prior experience in care coordination, case management, or working with dual-eligible populations preferred.
• Medicaid and/or Medicare managed care experience preferred.
• Clinical field/community-based training is a plus.
• Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or Licensed Mental Health Counselor (LMHC) required.
• Case Management Certification is highly preferred.
• Valid driver’s license, vehicle, and verifiable insurance required.
• Must reside in the same territory assigned to work in; exceptions may be considered due to business need.
• Must live within commutable distance to the Commonwealth of Massachusetts.
• Annual Influenza vaccination required (October 1 – March 31).

Skills

• Intermediate proficiency in Microsoft Office (Outlook, Word, Excel).
• Understanding of Medicare and Medicaid programs, as well as community resources for dual-eligible beneficiaries.
• Strong interpersonal and communication skills to engage with members, families, and healthcare providers.
• Ability to manage multiple cases and priorities while maintaining attention to detail.
• Adherence to a professional code of ethics.
• Awareness of and sensitivity to diverse backgrounds and needs.
• Strong decision-making and problem-solving skills.
• Ability to function independently and effectively as part of an interdisciplinary team.
• Strong written and verbal communication skills.
• Strong customer service skills.

Schedule

• Mobile position requiring regular travel to homes, offices, or other public settings.
• Flexible hours, including possible evenings and/or weekends to serve member needs.
• May require travel greater than 50% of the time.
• Must be exposed to weather conditions typical of the location and may be required to stand or sit for long periods.

Pay

$80,000 - $120,000 annually. Salary is based on a combination of education, training, experience, scope and complexity of the role, discretion required, and external/internal data. Bonus opportunities may be available based on company and individual performance.

Benefits

CareSource offers a substantial and comprehensive total rewards package focused on employee well-being.