Behavioral Health Case Manager

Blue Cross and Blue Shield of Louisiana•Remote-LA, LA

19h

About The Position

The Behavioral Health Case Manager coordinates and manages behavioral health services for members enrolled in Medicare and Commercial insurance plans, by telephone or in person. The role includes comprehensive assessment, evaluation, care planning, service coordination, and ongoing monitoring to help members receive timely and appropriate care. The case manager collaborates with internal teams, external providers, family members, and community resources to support care and improve health outcomes. The position also handles crisis calls, providing immediate intervention and risk assessment and coordinating emergency services when needed. The role participates in staffing the company's 24/7/365 crisis call line, including a regular rotation to answer calls outside normal business hours, on weekends, and on holidays. Duties are performed in a normal, clean office environment with normal noise levels. Work is predominantly performed while standing or sitting.

Requirements

Bachelor’s degree in nursing, healthcare, or a related field, or a master’s degree in social work, counseling, or behavioral health. A Louisiana RN license may replace the bachelor’s degree; a Louisiana LPN license plus two years of related experience may also replace it.
At least three years of experience in case management that includes behavioral health, behavioral health clinical practice, or behavioral health crisis intervention.
Current LPC, LCSW, LMFT, RN, or LPN license.
Strong clinical assessment and critical-thinking skills.
Excellent communication and interpersonal abilities.
Strong understanding of behavioral health diagnoses and treatment modalities.
Proficiency with electronic health records and case management systems.
Ability to work independently and as part of a multidisciplinary team.
Ability to make decisions based on established policies and procedures.
Comfort working in a fast-paced, dynamic environment with rotating crisis-line responsibilities.
Applicants must be authorized to work for Louisiana Blue in the United States without employer-sponsored immigration support.

Nice To Haves

Case Management Certification is preferred; if not already held, it must be attained within three years after the date of hire.
Experience working with Medicare and Commercial populations.
Experience in a managed care or health insurance setting.
Familiarity with CPT codes and billing practices.
Experience in crisis intervention and de-escalation techniques.
Residency in or relocation to Louisiana is preferred.

Responsibilities

Conduct comprehensive behavioral health assessments to identify member needs, strengths, and goals.
Develop, implement, and monitor individualized care plans with members, families, and providers.
Identify and coordinate behavioral health services across inpatient, outpatient, and community-based care.
Facilitate transitions between levels of care and ensure follow-up after hospitalizations or emergency interventions.
Educate and support members and families regarding behavioral health conditions, treatment options, and community resources.
Collaborate with Utilization Management, Customer/Member Services, medical case managers, primary care providers, and behavioral health specialists to support integrated care.
Document case management activities in accordance with regulatory and organizational standards.
Participate in interdisciplinary case rounds and quality improvement initiatives.
Staff the 24/7/365 crisis call line on a rotating schedule, providing crisis intervention, risk assessment, and coordination of emergency services as needed, including outside normal business hours, weekends, and holidays.
Maintain current knowledge of behavioral health best practices, regulatory requirements, and community resources.
Perform other job-related duties within the scope of responsibilities.