Behavioral Health Case Manager

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

2d•Hybrid

About The Position

Telephonic or in-person, coordination and management of behavioral health services for members enrolled in both Medicare and Commercial insurance plans. This role involves comprehensive assessment, evaluation, care planning, service coordination, and ongoing monitoring to ensure members receive timely, appropriate, and effective behavioral health care. The Behavioral Health Case Manager will collaborate with internal teams, external providers, family members, and community resources to support members in optimizing care and improving health outcomes. Will also receive and resolve crisis calls from plan members and provide immediate crisis intervention, risk assessment, and coordination of emergency services as needed.

Requirements

Bachelor’s degree in nursing, healthcare, or a related field OR master’s degree in social work, counseling, or behavioral health
RN license in Louisiana can replace Bachelor's degree OR LPN license in Louisiana + 2 years of related experience can replace the bachelor’s degree
Minimum of three years of experience in case management which includes behavioral health, behavioral health clinical practice, or behavioral health crisis intervention
LPC, LCSW, LMFT, RN, or LPN license required
Strong clinical assessment and critical thinking skills
Excellent communication and interpersonal abilities
Strong understanding of behavioral health diagnoses and treatment modalities
Proficiency in 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
Comfortable working in a fast-paced, dynamic environment with rotating crisis line responsibilities

Nice To Haves

Case Management Certification preferred but must be attained within 3 years after 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

Responsibilities

Conduct comprehensive behavioral health assessments to identify member needs, strengths, and goals.
Develop, implement, and monitor individualized care plans in collaboration with members, families, and providers.
Identify and coordinate behavioral health services across the continuum of care, including inpatient, outpatient, and community-based services.
Facilitate level of care transitions and ensure follow-up after hospitalizations or emergency interventions.
Provide education and support to 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 ensure integrated care.
Document all case management activities in compliance with regulatory and organizational standards.
Participate in interdisciplinary case rounds and quality improvement initiatives.
Actively participate in staffing the company’s 24/7/365 crisis call line, providing immediate crisis intervention, risk assessment, and coordination of emergency services as needed. Regularly participate in the schedule rotation to ensure staff availability to immediately answer crisis calls outside of normal business hours to include weekends and holidays.
Maintain up-to-date knowledge of behavioral health best practices, regulatory requirements, and community resources.
Perform other job-related duties as assigned, within your scope of responsibilities.