Perform case management telephonically within the scope of licensure for members with behavioral health, physical health, and substance abuse disorder needs
Respond to more complex cases and account-specific requests
Use appropriate screening criteria knowledge and clinical judgment to assess member needs
Conduct assessments to identify individual needs and develop specific care plans
Monitor and evaluate effectiveness of care plans and modify as needed
Support member access to appropriate quality and cost-effective care
Coordinate with internal and external resources to meet identified needs and collaborate with providers
Identify members at high risk for complications and coordinate care with the health care team
Identify members that would benefit from an alternative level of care or other waiver programs
Assist in problem-solving with providers and the health care team
Serve as a resource to other Case Managers
Participate in cross-functional teams, projects, and initiatives

MA/MS in social work, counseling, or a related behavioral health field, or a degree in nursing
Minimum of 3 years of clinical experience in social work counseling with complex psychiatric and substance abuse disorder treatment
Current active unrestricted license (LCSW, LPC, LMHC, LMFT, or RN) to practice as a health professional from the state of residence
Previous experience in case management and telephonic/in-person coaching
Managed care experience is strongly preferred
Health coaching and motivational interviewing techniques are preferred
Experience working on multiple computer platforms simultaneously
Strong typing skills are needed
Experience navigating whole health, including physical health, is strongly preferred

Behavioral Health Case Manager I

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