Clinical Care Manager

3 days ago


Philadelphia, Pennsylvania, United States Community Behavioral Health. Full time
Job Overview

We are seeking a skilled Clinical Care Manager to join our team as a Community Case Specialist. In this role, you will work collaboratively with members and providers to ensure effective, holistic care.

About the Role

This is a hybrid position that requires regular travel within Philadelphia and surrounding counties. You will be responsible for facilitating care coordination, conducting utilization review activities, population management, cross-system consultation, and treatment quality monitoring.

Key Responsibilities
  • Work directly with members, natural supports, and providers in the community, including in members' homes.
  • Facilitate care coordination using an inter-generational approach, addressing social determinants, barriers to wellness, and other needs of members.
  • Facilitate family Plan of Care meetings for assigned members monthly.
  • Be knowledgeable about behavioral health care services, system partners, service continuum, and established medical necessity criteria.
  • Complete Utilization Management activities, including interagency meetings, social determinants interviews, treatment team meetings, case consultations, care coordination, provider meetings, reviews, treatment linkage, and authorization of treatment when Medical Necessity Criteria is met.
Requirements
  • Master's degree in Social Work or related field.
  • Clinical licensure: Qualified candidates must obtain license within 18 months of employment.
  • Relevant work experience: Minimum of 3 years of direct clinical care experience working with adults, children, adolescents, and/or their families in behavioral health settings.

Salary: $65,000 - $85,000 per year, depending on experience.



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