Clinical Case Manager, Behavioral Health

The Clinical Case Manager, Behavioral Health, is responsible for telephonic assessment, planning, implementing, and coordinating care management activities with members to ensure their medical and behavioral health needs are met and to enhance their overall wellness. They will develop proactive courses of action, conduct comprehensive assessments of member needs, and apply clinical judgment to strategies designed to reduce risk factors and address complex clinical and social indicators. The role involves crisis intervention and follow-up, interpreting criteria and guidelines, serving as a point of contact for members, consulting with staff and providers, presenting cases at conferences, and collaborating with interdisciplinary care teams. This includes identifying and escalating quality of care issues.