Clinical Care Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Perform comprehensive assessments, identify obstacles, create tailored care plans, and modify interventions as necessary.

• Oversee behavioral health services, manage care transitions, develop crisis prevention strategies, and coordinate aftercare.

• Collaborate with members, healthcare providers, and medical management teams from health plans.

• Establish trusting relationships through motivational interviewing, education, and consistent communication.

• Act as the primary contact for members.

• Facilitate the exchange of information, plan for discharges, and connect members to behavioral health, community, and support services.

• Ensure documentation and service authorization are accurate and completed in a timely manner.

• Implement medical necessity criteria, adhere to regulatory requirements, follow accreditation standards, and comply with internal policies.

• Engage in audits, quality improvement initiatives, case presentations, and ongoing professional development.

• Promote high-quality care delivery and effective resource utilization.

⛳️ Requirements

• Possession of a current, unrestricted state license to practice independently as a Clinical Social Worker, Marriage and Family Therapist, Professional Counselor, Clinical Psychologist, or Registered Nurse in the relevant state(s).

• 3-5 years of hands-on clinical care experience in facility-based and/or outpatient behavioral health or substance use treatment environments.

• Strong clinical judgment coupled with effective case management abilities.

• Capacity to assist members through complex transitions in care.

• Exceptional verbal and written communication skills, emphasizing empathy and clarity.

• Proficient in Microsoft Outlook and Word applications.

• Ability to document interactions in real-time while engaging with members.

• Skill in interpreting and applying medical policies and clinical criteria.

• Must successfully pass a background check upon hire and throughout employment, covering criminal records, employment history, education, sanctions, prohibited parties, and drug screening.

• High-speed cable or fiber-optic internet connection required before starting, with a minimum of 20 Mbps download speed, 5 Mbps upload speed, and a maximum latency of 100 ms.

• A quiet workspace with minimal background noise is essential.

• A hardwired internet connection is necessary.

• Ability to work from a fixed, designated workspace at home.

• Must be able to sit for extended periods and utilize wired headsets and desktop equipment.

🏝️ Benefits

• Annual performance-based discretionary incentive.

• Medical, dental, and vision insurance coverage.

• 401(k) plan with a competitive employer matching contribution.

• Company-funded life and disability insurance.

• Paid parental leave along with wellness incentives.

• Generous paid time off, which includes time for volunteering.

• Flexible spending accounts available for healthcare and dependent care expenses.

• Opportunities for professional development and tuition reimbursement.

• Flexibility for remote work (depending on the role).

• Opportunities for meaningful personal and professional growth.

• Equipment provided by the company.