The Behavioral Health Case Manager serves as a primary clinical resource for members experiencing behavioral health challenges. This role uses a strengths-based, person-centered approach to help members better understand and manage their behavioral and physical health needs.
The Case Manager works collaboratively with members to identify strengths, needs, and goals, develop individualized care plans, and coordinate with healthcare providers. Using motivational interviewing, the Case Manager helps members overcome barriers to care, navigate the healthcare system, and access appropriate resources and services.
Key Responsibilities:
- Telephonically engage members with behavioral health challenges and identify barriers to care, including Social Determinants of Health (SDOH).
- Assess member strengths, needs, and goals and facilitate the development of individualized care plans.
- Provide follow-up support when clinically appropriate and requested by the member.
- Collaborate with members and their healthcare teams, particularly in complex behavioral health situations requiring changes to the care plan.
- Connect members with appropriate online, telephonic, and community-based resources.
- Help members maximize available benefits and coordinate appropriate healthcare services.
- Provide clinical assessment, intervention, and support to members seeking behavioral health assistance through inbound calls.
- Use motivational interviewing to help members overcome barriers and improve adherence to appropriate treatment and services.
Qualifications:
- Active Pennsylvania RN license (BSN preferred), LCSW, LSW, or LPC required.
- Minimum 3–5 years of post-licensure experience in an integrated care setting, hospital, or other healthcare setting.
- Strong understanding of Social Determinants of Health and Motivational Interviewing.
- Ability to independently resolve complex behavioral, medical, and psychosocial issues using strong critical-thinking skills.
- Strong assessment and engagement skills, including the ability to provide support through telephonic and virtual interactions.
- Ability to meet individual productivity goals while providing quality, cost-effective member support.
- Strong problem-solving and organizational skills.
- Excellent interpersonal, relationship-building, customer service, and teamwork skills.
- Strong computer skills, including experience with Microsoft Office Suite.