Clinical Care Management Specialist

4 weeks ago


Philadelphia, Pennsylvania, United States Community Behavioral Health Full time
Job Description

The Clinical Care Manager (CCM) Specialist is a critical member of our team, responsible for providing high-intensity care management to our members. This role requires a strong understanding of behavioral health care services, system partners, and established medical necessity criteria.

Key Responsibilities:

  • Work directly with members, natural supports, and providers in the community to facilitate care coordination and address social determinants, barriers to wellness, and other needs of members.
  • Create and maintain a team of system partners and natural supports for each member and their family.
  • Complete an effective Crisis Prevention Plan in collaboration with each assigned member and their team.
  • Attend up to 3 hours of group or individual skills-based coaching/supervision per week.
  • Complete Utilization Management activities, including interagency meetings, social determinants interviews with members, treatment team meetings, case consultations, care coordination, provider meetings, reviews, treatment linkage, within established timeframes.
  • Authorize treatment when Medical Necessity Criteria is met.
  • Consult with Physician Advisor, Psychologist Advisor, and/or Clinical Leadership as clinically appropriate.
  • Generate denial letters based on physician reviews and in accordance with state regulations as needed.
  • Demonstrate an understanding of Evidence-Based Practices (EBPs) and connect members to appropriate evidence-based treatment.

Team Specific Responsibilities:

  • Facilitate monthly interagency HFW Planning Meetings (includes youth/family participation) for a caseload of approximately 10 members and their families.
  • Write, revise, and distribute individualized Wraparound Plans and Discovery documents to member's teams monthly.
  • Ensure that the principles and steps of the High-Fidelity Wraparound process are delivered with the highest possible fidelity.
  • Provide evidence-based intensive care management interventions directly to members in the community.
  • Maintain a care management caseload of approximately 10 members (or as otherwise directed).

Requirements:

  • Master's degree in social work or related field.
  • Qualified candidates are required to obtain license within the first 18 months (1.5 years) of employment; PA Child Abuse Clearance required.
  • PA Licensed Social Worker (LSW), PA Licensed Professional Counselor (LPC), PA Licensed Marriage and Family Therapist (LMFT), PA Licensed Clinical Social Worker (LCSW).
  • Must obtain High-Fidelity Wraparound Facilitator credential within 1 year of hire.

Work Environment:

  • Must be able to regularly travel within Philadelphia and surrounding counties.
  • 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.


  • Philadelphia, Pennsylvania, United States Community Behavioral Health. Full time

    Job SummaryCommunity Behavioral Health (CBH) is seeking a highly skilled Clinical Care Management Specialist to join our team. As a Clinical Care Management Specialist, you will play a critical role in providing high-intensity care management to children and families in need. This is a unique opportunity to make a meaningful difference in the lives of our...


  • Philadelphia, Pennsylvania, United States Community Behavioral Health Full time

    Job DescriptionThe Clinical Care Manager (CCM) Specialist is a key member of the Community Behavioral Health (CBH) team, responsible for providing high-intensity care management to children and adolescents with complex behavioral health needs. The CCM Specialist will work collaboratively with members, their caregivers, and providers to ensure effective,...


  • Philadelphia, Pennsylvania, United States Community Behavioral Health. Full time

    Clinical Care Management SpecialistWe are seeking a highly skilled Clinical Care Management Specialist to join our Complex Care team at Community Behavioral Health. As a key member of our team, you will be responsible for providing intermediate or high-intensity care management to individuals and families in need of support.Key Responsibilities:Conduct...


  • Philadelphia, Pennsylvania, United States Community Behavioral Health. Full time

    Job Title: Clinical Care Management Specialist FOCUSCommunity Behavioral Health (CBH) is seeking a highly skilled Clinical Care Management Specialist to join our team. As a Clinical Care Management Specialist, you will play a critical role in providing intermediate or high-intensity care management to our members. Your expertise will be instrumental in...


  • Philadelphia, Pennsylvania, United States The Children's Hospital of Philadelphia Full time

    Job SummaryThe Children's Hospital of Philadelphia is seeking a skilled Clinical Care Specialist to join our team. As a key member of our Lysosomal Storage Disorders Program, you will be responsible for providing high-quality patient care and management of metabolic disorders.ResponsibilitiesPrepare for clinic visits by reviewing patient information and...


  • Philadelphia, Pennsylvania, United States Children's Hospital of Philadelphia Full time

    Job SummaryThe Children's Hospital of Philadelphia is seeking a skilled Clinical Care Specialist to join our team. As a key member of our Lysosomal Storage Disorders Program, you will be responsible for providing high-quality patient care, collaborating with multidisciplinary teams, and contributing to research and education initiatives.Key...


  • Philadelphia, Pennsylvania, United States The Children's Hospital of Philadelphia Full time

    Job Title: Clinical Nurse Specialist Utilization ManagementChildren's Hospital of Philadelphia (CHOP) is seeking a highly skilled Clinical Nurse Specialist Utilization Management to join our team. As a key member of our Utilization Management department, you will play a critical role in ensuring that patients receive the most appropriate and effective...


  • Philadelphia, Pennsylvania, United States Community Behavioral Health Full time

    Job SummaryWe are seeking a highly skilled Clinical Care Manager Specialist to join our Children's Complex Care team at Community Behavioral Health. As a key member of our team, you will be responsible for providing high-intensity care management to our members, working collaboratively with them and their providers to ensure effective, holistic, and...


  • Philadelphia, Pennsylvania, United States Jefferson Health Full time

    Job Title: Clinical Documentation Improvement Specialist ManagerJefferson Health is seeking a highly skilled Clinical Documentation Improvement Specialist Manager to join our team. As a key member of our Health Information Management department, you will be responsible for leading the Clinical Documentation Improvement Program at Jefferson Hospital...


  • Philadelphia, Pennsylvania, United States Children's Hospital of Philadelphia Full time

    Job SummaryWe are seeking a highly skilled Nurse Practitioner to join our team at the Children\u0027s Hospital of Philadelphia. As a Clinical Care Specialist, you will provide high-quality, patient-centered care to a diverse population of children and families.Key ResponsibilitiesManage a cohort of patients, perform daily assessments, and develop...


  • Philadelphia, Pennsylvania, United States The Children's Hospital of Philadelphia Full time

    Job SummaryAs a Clinical Care Specialist at The Children's Hospital of Philadelphia, you will provide high-quality patient care as a Nurse Practitioner. In collaboration with an attending physician, you will work with a patient population that matches your skill set and collaborate with a range of healthcare professionals. You will engage in professional...


  • Philadelphia, Pennsylvania, United States Temple Health Full time

    Job DescriptionWe are seeking a skilled Clinical Nurse Specialist to join our team at Temple Health, where you will play a vital role in providing high-quality patient care in our outpatient setting.About the RoleThe Clinical Nurse Specialist will be responsible for assessing, implementing, and evaluating patient care under the direction of licensed...


  • Philadelphia, Pennsylvania, United States Temple University Health System Full time

    As a skilled Clinical Care Specialist at Temple University Health System, you will be responsible for assessing, implementing, and evaluating care needed by assigned patients under the direction of a licensed physician. You will be knowledgeable about principles, theories, current methods, and techniques of nursing practice.Using the nursing process, you...


  • Philadelphia, Pennsylvania, United States Temple Health Full time

    Job SummaryClinical Nurse Specialist-Critical CareWe are seeking a highly skilled Clinical Nurse Specialist-Critical Care to join our team at Temple Health. As a key member of our nursing staff, you will be responsible for assessing and evaluating the clinical practices of our nursing staff, collaborating with the Nurse Manager and Assistant Nurse Manager to...


  • Philadelphia, Pennsylvania, United States HexaQuEST Health, Inc. Full time

    Job Requirements:As a skilled Clinical Care Specialist at HexaQuEST Health, Inc., you will be responsible for providing high-quality patient care and services. This role requires a strong background in nursing and the ability to work effectively in a fast-paced environment.Key Responsibilities:Assess patient needs and develop individualized care...


  • Philadelphia, Pennsylvania, United States Temple Health Full time

    Critical Care Clinical Nurse Specialists at Temple Health play a vital role in assessing and evaluating the clinical practices of the nursing staff, working closely with the Director of Nursing to ensure high-quality patient care.They collaborate with the Nurse Manager and Assistant Nurse Manager to identify educational needs related to clinical nursing and...

  • Nurse Care Specialist

    4 weeks ago


    Philadelphia, Pennsylvania, United States BAYADA Home Health Care Full time

    BAYADA Home Health Care is seeking a compassionate and dedicated Nurse Care Specialist to join our Hospice team. This role offers a unique opportunity to provide palliative care to clients in the comfort of their own homes.Responsibilities:Make home visits to clients in designated geographic territories.Perform assigned duties, including administration of...


  • Philadelphia, Pennsylvania, United States Children's Hospital of Philadelphia Full time

    Transforming Pediatric CareAt Children's Hospital of Philadelphia, we are committed to delivering exceptional care to our patients and families. As a Clinical Nurse Specialist, you will play a vital role in providing expert family-centered clinical care and clinical consultation to improve outcomes and promote integrated healthcare.Key...


  • Philadelphia, Pennsylvania, United States Temple University Hospital Full time

    Clinical Nurse Specialist-Critical CareCritical Care Clinical Nurse Specialists play a vital role in assessing and evaluating the clinical practices of nursing staff. In collaboration with the Director of Nursing, they identify areas for improvement and develop programs to address these needs. This role requires a high degree of professional excellence, with...

  • Clinical Assistant II

    4 weeks ago


    Philadelphia, Pennsylvania, United States Solis Mammography Full time

    Job Summary:Clinical Assistant II - Patient Care SpecialistSolis Mammography is seeking a highly skilled and compassionate Clinical Assistant II - Patient Care Specialist to join our team. As a Clinical Assistant II - Patient Care Specialist, you will play a vital role in providing exceptional patient care and support in our breast health services.Key...