Clinical Care Manager - Integrated Care

Job Description

Job Description

Clinical Care Manager - Integrated Care - Adult Community Based Care Management (CBCM)

Full Time

Philadelphia, PA, US

The Clinical Care Manager is responsible for utilization management by conducting utilization review activities, population management, cross-system consultation, provider management and treatment quality monitoring. The Clinical Care Manager must utilize clinical knowledge of best practices and evidence-based treatments to ensure CBH members receive timely access to quality, medically necessary behavioral health services. When clinically indicated, Clinical Care Managers consult with CBH Physician and Psychologist Advisors to ensure the most effective treatment for the CBH member is being authorized. The Clinical Care Manager will work to enhance physical and behavioral health care coordination and assist with mitigating social determinants of health (SDOH).

This is a hybrid position with 2-3 days spent offsite at physical health sites and community based organizations. In this role, the care manager will assist members visiting these sites with connecting to behavioral health services and connection to social services to address SDOH barriers.

Team Specific Responsibilities :

• Offsite member engagement in a physical health or community-based organization 2-3 days a week.
• Facilitate care coordination with external stakeholders.
• Complete integrated care plans to promote collaboration with physical health providers and system partners.
• Connection to behavioral health and community resources via telehealth and phone interactions with members.
• Complete SDOH and other evidence-based risk assessment tools.

Other Essential Functions :

Position Requirements :

Skills :

Philadelphia Residency Requirement :

Equal Employment Opportunity :

Requesting An Accommodation :