Serve as the central point of contact for patients enrolled in the BHI or CoCM program.
Conduct routine behavioral health screenings (e.g., PHQ-9, GAD-7) and track patient progress over time.
Provide patient outreach, psychoeducation, and support between clinical visits.
Collaborate with the psychiatric consultant and primary care provider (PCP) to review patient progress and adjust care plans accordingly.
Document all patient interactions, screenings, care plan updates, and psychiatric recommendations in the medical record.
Monitor patient adherence to behavioral health treatment plans and assist with follow-up care coordination.
Ensure patient consent for collaborative care is obtained and documented prior to billing.
Assist patients in overcoming barriers to care (e.g., scheduling, transportation, understanding treatment).
Coordinate referrals to specialty mental health providers as needed.
Support billing processes by maintaining compliance with time tracking, service documentation, and care plan updates as required by CMS and commercial insurers.

Bachelor’s or Master’s degree in Social Work, Psychology, Counseling, Nursing, Public Health, or a related field.
Prior experience in behavioral health, care coordination, or chronic disease management preferred.
Familiarity with behavioral health screening tools (PHQ-9, GAD-7, etc.).
Understanding of the Collaborative Care Model and/or BHI billing requirements is highly desirable.
Strong communication and interpersonal skills to work with patients, families, and multidisciplinary teams.
Proficiency in electronic health record (EHR) documentation and case management workflows.
Bilingual abilities are a plus.

Behavioral Health Care Manager

Key skills