Behavioral Health Care Manager

Rapid Care Solutions

395d • $75,000 - $85,000 • Remote

About The Position

The Behavioral Health Care Manager is responsible for facilitating care for members and their families who may have rising health risks or complex healthcare needs. This role promotes optimal health through self-directed and collaborative care management, focusing on assessing needs, identifying health care disparities, and overcoming barriers to care.

Requirements

• Active licensure in New York as LMHC, LICSW, or LCSW is required.
• 3-5 years of relevant experience in various clinical health care settings (inpatient, outpatient, etc.).
• Case Management experience is required.
• Proficient with multiple IT systems.
• Ability to identify and document member-driven, specific, measurable activities that address actionable behaviors and goals.

Nice To Haves

• Knowledge of Medicaid and managed care regulations and requirements preferred.
• Certifications such as Case Management (CCM) or certified diabetic educator are a plus.

Responsibilities

• Engage members in appropriate plans of care and coordinate care and services as needed.
• Promote member compliance with treatment plans and encourage shared decision-making.
• Interpret and apply case management criteria, processes, policies, and regulatory standards to document comprehensive care management plans.
• Review medication lists and educate members on complex pharmacy needs, including counseling on side effects.
• Connect, engage, and maintain member engagement to support seamless care transitions.
• Interact with treatment providers, PCPs, physicians, therapists, and facilities to gather clinical information.
• Monitor clinical quality concerns and make appropriate referrals, escalating quality of care issues as necessary.
• Understand member insurance products and benefits, as well as regulatory and NCQA requirements.

Benefits

• Health insurance
• Dental insurance
• 401(k)
• Paid time off
• Flexible schedule

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed