Behavioral Health Care Management Manager

📋 Description

• Offer clinical leadership and oversight for behavioral health care management programs for both adult and pediatric populations.

• Ensure that behavioral health interventions are evidence-based, measurement-driven (e.g., PHQ-9, GAD-7, PROMIS), and aligned with the objectives of value-based care.

• Act as a subject matter expert for complex behavioral health cases, which include severe mental illness, transitions in inpatient and post-acute behavioral health, crisis intervention, and high-utilization members.

• Collaborate with senior leadership to formulate and implement the CCM behavioral health strategy, specialty care pathways, and program enhancements.

• Directly supervise and develop a team of behavioral health clinicians, providing coaching, mentorship, and performance management.

• Cultivate psychological safety, clinical excellence, and accountability in a virtual care environment.

• Lead the onboarding, training, and ongoing clinical education to ensure consistency, quality, and confidence throughout the team.

• Identify skill gaps and work with leadership to create targeted training and upskilling initiatives.

• Manage day-to-day behavioral health operations, including the distribution of workloads, caseload equity, staffing alignment, and optimization of workflows.

• Ensure timely access to care, appropriate triage, and escalation for high-risk behavioral health cases.

• Collaborate across various functions with Utilization Management, Navigation, Product, Clinical Affairs, and Quality teams to ensure integrated, closed-loop care delivery.

• Ensure compliance with clinical standards, regulatory requirements, and professional practice guidelines in behavioral health care.

• Monitor quality metrics, audit results, and client performance indicators; lead corrective actions and continuous improvement initiatives.

• Collaborate with Quality and Compliance teams to mitigate clinical risk and support audit readiness.

• Track and analyze behavioral health performance metrics, including engagement, outcomes, utilization impact, and quality scores.

• Utilize data to inform staffing decisions, refine workflows, and enhance care models.

• Prepare and deliver performance insights to senior leadership and client stakeholders as needed.

⛳️ Requirements

• Nurse Practitioner (NP) or Master of Science in Nursing (MSN) from a recognized nursing program.

• Active, unrestricted RN license in at least one U.S. state (multi-state licensure is preferred).

• At least 5 years of clinical experience in behavioral health, including work with complex, high-acuity populations.

• Minimum of 3 years of experience in people management, leading clinical teams within healthcare settings.

• Proven expertise in behavioral health assessment, treatment planning, crisis management, and care coordination.

• Experience in virtual, telehealth, or population health models is highly preferred.

• Strong data literacy, with the capability to interpret performance metrics and translate insights into actionable steps.

• Exceptional communication, leadership presence, and relationship-building abilities.

• Capacity to lead through change, manage competing priorities, and perform effectively in a fast-paced environment.

• Experience in value-based care, population health, or complex care management programs is preferred.

• Prior leadership experience managing interdisciplinary or specialty behavioral health teams is preferred.

• Familiarity with NCQA, ACMA, or other relevant accreditation standards is preferred.

• Experience collaborating with Utilization Management, payer organizations, or external behavioral health providers is preferred.

🏝️ Benefits

• Remote-first culture

• 401(k) savings plan through Fidelity

• Comprehensive medical, vision, and dental coverage through several medical plan options (including disability insurance)

• Full suite of Included Health telemedicine (e.g., behavioral health, urgent care, etc.) and healthcare navigation products and services available at no cost for employees and their dependents

• Generous Paid Time Off ("PTO") and Discretionary Time Off (“DTO”)

• 12 weeks of 100% Paid Parental leave

• Family Building Benefit including fertility coverage and up to $25,000 for Surrogacy & Adoption financial assistance

• Compassionate Leave (paid leave for employees who undergo a failed pregnancy, surrogacy, adoption, or fertility treatment)

• 11 Holidays Paid along with one Floating Paid Holiday

• Work-From-Home reimbursement to facilitate team collaboration and effective home office work

• 24 hours of Paid Volunteer Time Off (“VTO”) per year to volunteer with charitable organizations