Care Manager

AltaPointe Health • Mobile, AL

13d

About The Position

The Care Manager coordinates physical, behavioral, and social health services for clients, working across AltaPointe programs and with external providers. The role includes reviewing clinical records and documenting findings, monitoring engagement and treatment-plan compliance, identifying gaps in care, facilitating access to community services, and managing referrals through closure. Care Managers support transitions after hospital discharge, follow up on missed appointments, monitor screening results and client risk, and communicate with the treatment team to promote continuity of care.

Care Managers manage an assigned caseload, respond to alerts, participate in team huddles and interdisciplinary discussions, and ensure documentation complies with agency, Medicaid, and CCBHC standards. They are expected to spend 80–90% of their time on direct patient care coordination activities. Required daily work includes assigned hospital, ED, and BHCC follow-ups; missed-appointment follow-ups; risk-prioritized referrals; and timely documentation. The position also involves supervision and consultation, participation in performance improvement and committees as required, adherence to agency policies, and required training.

Requirements

• At least 2 years of experience in behavioral health, care coordination, case management, or related healthcare service delivery.
• Bachelor’s degree in behavioral health, human services, nursing, public health, or a related field is preferred; alternatively, a high school diploma or equivalent and 4 years of relevant experience.
• Strong knowledge of behavioral health systems, including mental health, substance use, and social determinants of health.
• Proficiency navigating and documenting in electronic health records, including coordination systems such as Avatar or equivalent.
• Experience with treatment planning, interagency coordination, and client engagement.
• Strong organizational and communication skills, including accurate documentation and task follow-up.
• Ability to work independently and as part of an interdisciplinary team.
• Ability to pass background checks and credentialing per agency standards.

Nice To Haves

• Experience with high-need populations, including SMI, SED, and SUD.
• Bachelor’s degree in behavioral health, human services, nursing, public health, or a related field.
• Valid driver’s license and reliable transportation may be required based on program location.

Responsibilities

• Review clinical records to assess service utilization, client engagement, and treatment-plan compliance.
• Document chart reviews, interactions, coordination efforts, and service linkages in the electronic health record and Care Manager System.
• Identify gaps in care, missed services, and follow-up needs, and take appropriate action.
• Coordinate physical, behavioral, and social health services across internal programs and external providers.
• Facilitate access to community services, including housing, benefits, employment supports, and substance use care.
• Generate, track, follow up on, and close referrals, confirming completion and appointment attendance.
• Conduct follow-up calls within 24 hours of psychiatric or medical hospital discharges.
• Confirm follow-up appointments and support understanding of discharge instructions.
• Notify care team members of transitions and facilitate continuity of care.
• Monitor attendance at therapy, psychiatry, and medical appointments; address disengagement through outreach or peer-support referrals.
• Review PHQ-9 and other screening tools to track clinical progress and inform care needs.
• Resolve referral barriers, including transportation, insurance, and documentation needs.
• Monitor client risk levels, report significant changes to the treatment team, and support crisis-response planning.
• Support treatment-plan implementation and coordinate updates as client needs or engagement change.
• Manage assigned caseloads, respond to alerts, complete scheduled reviews, and staff cases with a supervisor regularly.
• Participate in team huddles, interdisciplinary case discussions, performance improvement activities, and required committees.
• Meet agency, Medicaid, CCBHC, and quality-assurance documentation standards and complete documentation daily.
• Attend required in-service training, workshops, and other trainings; follow AltaPointe policies and procedures.
• Treat patients, visitors, and coworkers respectfully, compassionately, and with regard for privacy and confidentiality.

What This Job Offers

• Job Type: Full-time