Care Manager
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Job Description
Care Manager coordinating and overseeing behavioral health services to enhance member engagement and recovery outcomes. Integrating care management and ensuring compliance with clinical standards across the continuum of care.
Responsibilities:
- The Care Manager coordinates and oversees behavioral health services to ensure members receive appropriate, high-quality care while promoting engagement, continuity, and recovery.
- Acting as a central point of contact, the role integrates care management, utilization management, and collaborative partnerships to optimize outcomes, support self-management, and ensure compliance with clinical, regulatory, and organizational standards.
- Conduct holistic assessments, identify barriers, develop individualized care plans, and adjust interventions to support recovery and self-management across the continuum of care.
- Coordinate behavioral health services, care transitions, crisis prevention plans, and aftercare by partnering with members, providers, and health plan medical management teams.
- Build trusting, collaborative relationships with members and providers using motivational interviewing, education, and ongoing communication to increase engagement and continuity of care.
- Serve as the single point of contact for members, facilitating information exchange, discharge planning, and connection to behavioral health, community, and support resources.
- Ensure accurate, timely documentation and service authorization in alignment with medical necessity criteria, regulatory requirements, accreditation standards, and internal policies.
- Participate in audits, quality improvement initiatives, case presentations, and ongoing professional development to support high-quality care delivery and optimal resource utilization.
Requirements:
- Current, unrestricted state license to independently practice as a Clinical Social Worker, Marriage and Family Therapist, Professional Counselor, Clinical Psychologist or Registered Nurse in the applicable state(s).
- 3-5 years of direct clinical care experience in facility-based and/or outpatient behavioral health or substance use treatment settings
- Strong clinical judgment and case management skills, with the ability to support members through complex care transitions.
- Excellent verbal and written communication skills, with a focus on empathy and clarity.
- Proficiency in Microsoft Outlook and Word, with the ability to document in real time while engaging with members.
- Ability to interpret and apply medical policy and clinical criteria.
- Ability to pass background check upon hire and throughout employment to include criminal felony & misdemeanor search, SSN validation/trace search (LEIE), education report (highest degree obtained), civil upper and lower search, 7-year employment report, federal criminal search, statewide criminal search, widescreen plus national criminal search, health care sanctions-state med (SAM), national sex offender registry, prohibited parties (OFAC) (terrorist watchlist), and a 10-Panel Drug Screen.
Benefits:
- Annual compensation between $65,000-$75,000, PLUS an annual performance-based, discretionary incentive.
- Comprehensive health benefit options: Medical, dental, and vision coverage
- 401(k) with competitive employer match
- Company-paid life and disability insurance
- Paid parental leave and wellbeing incentives
- Generous paid time off, including volunteer time
- Flexible spending accounts for healthcare and dependent care
- Professional development opportunities and tuition reimbursement
- Remote work flexibility (role-dependent)
- Opportunity for meaningful growth, both personally and professionally, where your unique background and experience is welcomed and valued.
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