Clinical Case Manager Behavioral Health - Commercial Plan

Behavioral Health Clinician (Work at Home)

Schedule: Standard business hours with one early-evening shift weekly (until 7pm, local time)

Holidays: Enjoy all major holidays off

Join a compassionate, mission‑driven team that empowers individuals to lead healthier, more fulfilling lives. As a Behavioral Health Clinician, you’ll use your clinical expertise to support members navigating physical and behavioral health challenges—helping them access the right care, at the right time, with the right support.

What You’ll Do Comprehensive Member Support

• Conduct holistic assessments using clinical tools and data insights to understand each member’s needs and eligibility for available services
• Develop tailored care plans by integrating benefit information and both internal and external resources
• Apply advanced clinical judgment to address risk factors and guide members toward improved health outcomes

Crisis Intervention & Care Coordination

• Provide skilled crisis intervention for members experiencing behavioral health or medical emergencies
• Coordinate follow-up care to ensure members connect with appropriate providers and services
• Collaborate closely with providers, supervisors, Medical Directors, and additional programs to reduce barriers and optimize care

Promoting Quality, Engagement & Better Health

• Apply clinical guidelines, criteria, and policies to support high-quality, medically appropriate care
• Use motivational interviewing and engagement strategies to empower members and encourage healthy behavior change
• Educate and coach members to participate confidently in their health decisions
• Monitor progress using clinical, self-reported, and utilization data to continuously refine care plans

Documentation & Care Monitoring

• Develop, track, and adjust individualized plans of care based on member goals
• Maintain compliance with accreditation standards and company policies using case management and quality management processes
• Ability to multitask effectively—including typing and talking with members simultaneously

Required Qualifications

• Master’s degree in a behavioral health field
• Minimum 3 years of post-master’s direct clinical experience (hospital, outpatient, ambulatory, or similar care settings)
• Strong knowledge of mental health and substance use disorders
• Experience with Motivational Interviewing
• Solid technological skills and comfort using digital tools in a remote environment

Licensure

Active, unrestricted, and independent behavioral health license in your state of residence.

Anticipated Weekly Hours

40