Clinical Case Manager – Behavioral Health SNP

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

📋 Description

• Conduct thorough evaluations of the needs and eligibility of referred members.

• Create strategies for case resolution and coordinate comprehensive psychosocial support services.

• Utilize clinical judgment to manage risk factors and intricate clinical indicators.

• Execute crisis intervention for members facing behavioral health or medical emergencies.

• Refer members to suitable clinical providers and ensure crisis follow-up is provided.

• Implement clinical criteria, guidelines, case management plans, policies, procedures, and regulatory standards.

• Collaborate with supervisors, Medical Directors, and other programs to address barriers to care.

• Present cases during case conferences for multidisciplinary evaluation.

• Identify and escalate issues related to quality of care.

• Advocate for appropriate member care through communication with medical and behavioral health professionals.

• Employ motivational interviewing techniques to encourage member engagement and promote lifestyle or behavioral changes.

• Provide coaching, information, and support to facilitate independent healthcare decisions.

• Analyze utilization, self-reported, and clinical data to assess comprehensive member needs.

• Develop and oversee care plans in collaboration with members and care teams.

• Document and manage care in adherence to regulatory, accreditation, and company standards.

⛳️ Requirements

• 3+ years of direct clinical practice experience following a master's degree, such as in a hospital, ambulatory care, or outpatient clinic/facility.

• 3+ years of knowledge regarding mental health and substance abuse disorders.

• 3+ years of experience in simultaneously talking, using the phone, and typing.

• 3+ years of experience with Motivational Interviewing and proficient technological skills.

• A valid unrestricted independent professional behavioral health clinical license to practice in accordance with state regulations in the state of residence; examples include LCSW, LSW, LISW, LCPC, LP, LMFT, or LMHC.

• A Master's Degree in Social Work or Counseling is mandatory.

• Availability to work Monday through Friday, 8:00 AM to 5:00 PM EST.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being.

• CVS Health bonus, commission, or short-term incentive program in addition to base pay.