BH Case Manager

St. John's Community Health; San Bernardino (CA); On-site; USD 95,000 - 120,000; Full time

Benefits offered by this job

Free Medical, Dental & Vision

13 Paid Holidays + PTO

401(k) retirement match

Life Insurance

Tuition Reimbursement

Flexible Spending Account

Workforce development & training

Job summary

St. John's Community Health is seeking a Behavioral Health Care Manager for the ECM program in California.

The BH CM will deliver comprehensive care management, behavioral health interventions, crisis support, and care coordination for individuals with serious mental illness and complex needs. You will partner with primary care, behavioral health professionals, hospitals, and community-based organizations to improve access, coordinate transitions of care, and promote positive outcomes.

Qualifications

• Master’s degree in social work or related field.
• 3+ years in behavioral health, care or case management.
• Experience with SMI, SUD, homelessness, complex needs.
• Knowledge of CalAIM, ECM, Medi-Cal.
• Strong care coordination and crisis intervention skills.
• Bilingual English/Spanish preferred.
• Experience using EHRs; quality improvement experience.

Responsibilities

• Manage a diverse caseload of members with SMI, SUD, and complex needs.
• Engage eligible members in ECM and support program goals.
• Provide evidence-based behavioral health interventions and crisis support.
• Develop and monitor Shared Care Plans addressing medical and social needs.
• Coordinate care across providers, hospitals, and community resources.
• Educate members/families and participate in team meetings.

Education

Master's degree

Tools

eClinicalWorks

Job description

Job Summary

The Behavioral Health Care Manager (BH CM) for the ECM program will provide comprehensive care management, behavioral health interventions, crisis support, care coordination, and member advocacy. The BH CM will support individuals with serious mental illness (SMI), substance use disorders (SUD), and complex medical and behavioral health needs through evidence-based interventions, motivational interviewing, behavioral activation, and collaborative care planning. BH CM will partner with primary care providers, behavioral health specialists, hospitals, community-based organizations, and interdisciplinary care team members to improve access to services, coordinate transitions of care, and promote positive health outcomes. The role provides member and family education, tracks clinical outcomes, develops person-centered Shared Care Plans, and empowers members to achieve greater self-management, wellness, and independence. They will serve as a clinical resource for the care team while fostering whole-person, integrated care for high-risk populations.

Job Summary

The Behavioral Health Care Manager (BH CM) for the ECM program will provide comprehensive care management, behavioral health interventions, crisis support, care coordination, and member advocacy. The BH CM will support individuals with serious mental illness (SMI), substance use disorders (SUD), and complex medical and behavioral health needs through evidence-based interventions, motivational interviewing, behavioral activation, and collaborative care planning. BH CM will partner with primary care providers, behavioral health specialists, hospitals, community-based organizations, and interdisciplinary care team members to improve access to services, coordinate transitions of care, and promote positive health outcomes. The role provides member and family education, tracks clinical outcomes, develops person-centered Shared Care Plans, and empowers members to achieve greater self-management, wellness, and independence. They will serve as a clinical resource for the care team while fostering whole-person, integrated care for high-risk populations.

On-Site Position

The position oversees health and psychosocial education, care coordination, patient advocacy, and documentation, ensuring services are delivered efficiently and aligned with organizational goals.

Benefits

• Free Medical, Dental & Vision
• 13 Paid Holidays + PTO
• 403 (B) retirement match
• Life Insurance, EAP
• Tuition Reimbursement
• Flexible Spending Account
• Continued workforce development & training
• Succession plans & growth within

Education & Experience

• Master’s degree in Social Work, Counseling, Psychology, Public Health, Nursing, or a related field preferred.
• Three (3) or more years of experience in behavioral health, care management, case management, population health, or integrated care settings.
• Experience serving individuals with serious mental illness (SMI), substance use disorders (SUD), homelessness, chronic medical conditions, and other complex needs.
• Knowledge of CalAIM, Enhanced Care Management (ECM), Community Supports, Medi-Cal managed care, and social determinants of health.
• Demonstrated skills in care coordination, care planning, crisis intervention, motivational interviewing, patient engagement, and multidisciplinary team collaboration.
• Strong knowledge of community resources, referral networks, patient advocacy, and systems of care for vulnerable populations.
• Experience using Electronic Health Records (EHRs), health information systems, data collection, reporting, quality improvement, and program evaluation methodologies.
• Excellent organizational, communication, and relationship-building skills with the ability to manage multiple priorities in a fast-paced environment.
• Bilingual English/Spanish preferred.

Licensure & Certifications

• Active California healthcare or behavioral health license/registration preferred (e.g., ACSW, LCSW, AMFT, LMFT, APCC, LPCC, RN, or equivalent).
• Valid California Driver’s License, reliable transportation, and ability to travel as required.
• CPR/First Aid certification preferred.
• Certified Case Manager (CCM) and/or Motivational Interviewing (MI) training preferred.
• Bilingual English/Spanish preferred.

Essential Duties And Responsibilities

• Manage a diverse caseload of members with serious mental illness (SMI), substance use disorders (SUD), and complex medical, behavioral health, and social service needs while providing comprehensive care management and ongoing member engagement.
• Conduct outreach, assessment, and enrollment activities to engage eligible members in the Enhanced Care Management (ECM) program and support program growth and participation goals.
• Provide evidence-based behavioral health interventions, motivational interviewing, behavioral activation, crisis intervention, safety planning, and therapeutic support to promote member wellness, self-management, and improved health outcomes.
• Develop, implement, and monitor individualized Shared Care Plans that address medical, behavioral health, housing, and social determinant needs while aligning with member goals and provider recommendations.
• Coordinate care across primary care providers, behavioral health professionals, specialists, hospitals, managed care plans, community-based organizations, and social service agencies to ensure integrated, whole-person care.
• Facilitate transitions of care by coordinating hospital admissions, discharges, referrals, follow-up appointments, and community resource connections to ensure continuity of services and reduce barriers to care.
• Educate members and families on chronic medical and behavioral health conditions, treatment options, community resources, and self-management strategies to improve health literacy and patient engagement.
• Lead and participate in multidisciplinary team meetings, case conferences, and care reviews to support collaborative decision-making and achievement of member-centered outcomes.

Maintain current knowledge of community resources, housing services, supportive programs, and referral networks to effectively connect members with appropriate services and supports.

• Provide guidance, mentorship, and clinical support to care team staff in collaboration with ECM leadership to promote best practices, program compliance, and quality service delivery.
• Ensure accurate, timely, and compliant documentation in Electronic Health Records (eClinicalWorks) and other required systems, including care plans, progress notes, assessments, and program-related data.
• Review and audit member charts and documentation to ensure compliance with managed care contracts, regulatory requirements, quality standards, and organizational policies.
• Monitor program performance and key quality metrics, support program evaluation activities, and identify opportunities for process improvement and enhanced member outcomes.
• Collaborate with ECM Registered Nurses, Program Managers, and interdisciplinary teams to integrate care management services into clinical workflows and support operational effectiveness.
• Develop and distribute educational, outreach, and promotional materials that enhance member engagement, staff knowledge, and program awareness.
• Participate in training, meetings, community events, and other organizational initiatives while performing additional duties as assigned to support program and organizational goals.