Clinical Care Manager at Community Behavioral Health.

Philadelphia, Pennsylvania, United States -

Full Time

Start Date

Immediate

Expiry Date

11 Aug, 26

Salary

0.0

Posted On

13 May, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Utilization Management, Care Coordination, Clinical Case Conceptualization, Treatment Planning, Crisis Consultation, Provider Engagement, Clinical Writing, Interdisciplinary Collaboration, Microsoft Excel, Behavioral Health Systems, Evidence-Based Practices, HIPAA Compliance, Case Management, Patient Advocacy, Cultural Humility, Medical Necessity Assessment

Industry

Non-profit Organization Management

Description

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. Essential Functions Utilization Management (UM) * 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. Care Coordination * 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. Provider Engagement & Quality Monitoring * 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. Clinical Consultation & Team Collaboration * 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. Documentation & Compliance * 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. System Knowledge & Advocacy * 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. Position Qualifications Education: * Master’s degree in Social Work or related clinical field required. Licensure/Certification: * 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: * 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. * Experience providing or overseeing services and/or managed care navigation preferred. Technical Skills: * Proficient in Microsoft Office, especially Excel, and able to type at least 40 words per minute. * Strong documentation and clinical writing skills. Core Competencies: * 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. Work Conditions (including travel, overtime required, physical requirements and occupational exposure): * Must be able to travel frequently In Philadelphia and surrounding counties. * Out-of-state travel may be required occasionally. * Regularly requires walking, standing, stooping, bending, sitting, reaching, pushing, pulling and/or repetitive wrist/hand movements for various lengths of time throughout the day. * Ability to utilize computers and office equipment to complete daily work responsibilities. * Regularly works inside in areas that are adequately lighted and ventilated. Some fluctuation in temperature. No protective equipment is routinely needed. * Must be able to adapt to continuous changes/demands of the job. We Offer: * Family Planning, Fertility, Adoption Benefits * Flexible work hours and work from home opportunities * 403B Retirement Plan * PTO Days/Sick Days/Wellness Days * Education Assistance * Wellness Program * Employee Assistance Program * Health, Dental, Vision Insurance * Medical, Prescription Drug Insurance * Commuter Benefits * Flexible Spending Philadelphia Residency Requirement: * The successful candidate must be a current Philadelphia resident or become a resident within six months of hire. U.S. Authorization Requirement: * CBH does not provide sponsorship for applicants requiring future work authorization. All candidates must be legally authorized to work in the United States without requiring sponsorship now or in the future. Equal Employment Opportunity: * We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CBH is an equal opportunity employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on all qualified individuals. This is without regard to race, ethnicity, creed, color, religion, national origin, age, sex/gender, marital status, gender identity, sexual orientation, gender identity or expression, disability, protected veteran status, genetic information or any other characteristic protected individual genetic information, or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function by applicable federal, state, or local law. Requesting An Accommodation: * CBH is committed to providing equal employment opportunities for individuals with disabilities or religious observance, including reasonable accommodation when needed. If you are hired by CBH and require an accommodation to perform the essential functions of your role, you will be asked to participate in our accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodation once hired. * If you would like to be considered for employment opportunities with CBH and have accommodation needs for a disability or religious observance, please send us an email at CBH.Recruitment@Phila.gov [CBH.Recruitment@Phila.gov]

Responsibilities

The Clinical Care Manager delivers integrated care management for individuals with complex behavioral needs, focusing on utilization management and care coordination. They facilitate collaboration between providers and members while monitoring treatment progress and health outcomes.