Clinical Care Manager

Community Behavioral Health.•Philadelphia, PA

1d•Hybrid

About The Position

The Clinical Care Manager (CCM) is responsible for delivering integrated, whole person care management to individuals with complex behavioral needs. The CCM facilitates care coordination across multiple systems, ensures timely utilization management (UM) activities, and promotes collaboration between providers, members, and support systems to improve health outcomes. Clinical Care Managers are assigned to specific teams based on population needs and service settings, with some responsibilities tailored to those contexts. The ideal candidate has strong clinical conceptualization skills, experience working with the Medicaid population, and is passionate about health equity for all Philadelphians.

Requirements

Master’s degree in Social Work or related clinical field required.
Minimum of 3 years of direct clinical experience providing behavioral health services to children, adolescents, and/or adults. This experience can be inclusive of practicum time and clinical experience pre-master's degree.
Demonstrated experience in assessment, treatment planning, and interdisciplinary care coordination.
Proficient in Microsoft Office, especially Excel, and able to type at least 40 words per minute.
Strong documentation and clinical writing skills.
Excellent clinical case conceptualization and proactive planning skills.
Strong facilitation skills for team meetings, trainings, and care conferences.
Ability to work both independently and collaboratively across teams.
Exceptional interpersonal, verbal, and written communication skills.
Familiarity with psychotropic medications and evidenced based behavioral health interventions.
Demonstrated flexibility, strong time management, and the ability to multi-task in a fast-paced environment.
Commitment to professional ethics and compliance with HIPAA and other regulatory standards.
Must be able to travel frequently In Philadelphia and surrounding counties.
The successful candidate must be a current Philadelphia resident or become a resident within six months of hire.
All candidates must be legally authorized to work in the United States without requiring sponsorship now or in the future.

Nice To Haves

Licensed Social Worker (LSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), or Licensed Clinical Social Worker (LCSW) preferred.
Candidates without clinical licensure must be eligible and willing to obtain full clinical licensure. If eligible for an associate license, must be obtained within 90 days of hire. Full licensure must be obtained within 18 months of hire.
PA Child Abuse Clearance required.
Experience providing or overseeing services and/or managed care navigation preferred.
Out-of-state travel may be required occasionally.

Responsibilities

Review and assess service requests in accordance with Medical Necessity Criteria and regulatory requirements.
Actively monitor course of treatment ensuring high quality whole person care.
Document UM activities in electronic systems and generate denial letters when applicable.
Conduct discharge reviews and concurrent reviews as assigned.
Complete UM activities within team specific productivity guidelines.
Participate in inter-agency/team meetings, treatment planning, and crisis consultations.
Facilitate member-centered collaboration with natural supports, providers, and system partners, addressing social determinants of health and other barriers.
Dependent on team needs work directly in the community with members/providers 6–15 days per month.
Conduct provider or stakeholder meetings (quarterly or more frequently).
Monitor length of stay, progress toward treatment goals, and provider performance.
Document quality concerns and collaborate with internal departments to address trends.
Consult with Physician Advisors, Psychologist Advisors, and Clinical Supervisors.
Participate in clinical case consultation, supervision, and department meetings.
Support onboarding and department coverage as needed.
Maintain accurate and timely documentation consistent with agency and industry standards.
Use data to inform clinical decisions and support provider accountability.
Respond to correspondence within 24–48 hours or sooner when necessary.
Maintain a daily log of work and participate in audits, reviews, or site visits.
Completion of required training.
Demonstrate working knowledge of behavioral health systems, service continuums, and Evidence-Based Practices (EBPs).
Advocate for members to receive care in least restrictive, recovery-oriented settings.
Uphold standards of customer service, family-driven care, and cultural humility.