EAP Clinical Case Specialist

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

📋 Description

• Deliver thorough clinical evaluations and solution-oriented guidance, advocacy, and support on every call.

• Evaluate clinical information and apply criteria for medical necessity.

• Oversee the activities of behavioral health physician advisors and consult on cases involving medical complexities.

• Manage discharge planning in collaboration with facilities, health service providers, members, and families.

• Facilitate care coordination and referrals to physical health providers, social services, and disability services.

• Document and address member and provider inquiries and complaints for first-level appeals.

• Triage crisis calls and assist in ensuring safety and access to appropriate care.

• Manage and triage Employee Assistance Program service calls.

• Ensure accurate and comprehensive documentation within the system.

• Carry out administrative tasks and additional assigned responsibilities.

⛳️ Requirements

• Experience in EAP clinical services, encompassing clinical call center operations, case management, crisis response, and employer-based programs.

• A Master’s degree in a behavioral health field is mandatory.

• Clinical licensure is required (LCSW, LPC, LMSW, or LMFT).

• Capability to work during Pacific Time Zone hours, from 8 am to 5 pm PST.

• Exceptional written and verbal communication skills.

• Prior experience in EAP and call center environments is necessary.

• Strong attention to detail is essential.

• Proficiency in using MS Office, SharePoint, and various collaboration tools.

• Ability to thrive in a fast-paced, team-oriented environment.

• SAP certification is required.

• Bilingual proficiency in Spanish and English is advantageous.

• Preferred 3–5 years of experience in a clinical setting.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and growth.

• Supportive work environment with a focus on team collaboration.