Job Description
ADMORE BEHAVIORAL HEALTH
Position Title:
Mental Health Case Manager Team Lead Department:
Case Management Reports To:
Clinical Director Employment Type:
Full-Time FLSA Status:
Exempt Position Summary The Mental Health Case Manager Team Lead is a frontline management role responsible for leading a team of mental health case managers who deliver community-based behavioral health services to Admore patients. This position holds direct accountability for team performance, weekly billing and utilization targets, caseload productivity, compliance with insurance documentation standards, and the professional development of all direct reports. The Team Lead serves as the operational link between clinical staff and organizational leadership, ensuring the team consistently meets quality, financial, and regulatory benchmarks while delivering compassionate, person-centered care. Key Responsibilities 1. People Performance & Management Set clear, measurable performance expectations for each case manager aligned with organizational goals, including weekly billing quotas, utilization rates, caseload targets, and documentation standards. Conduct regular one-on-one supervision meetings (minimum weekly) to review individual performance, address barriers, provide real-time coaching, and deliver actionable feedback. Facilitate group team meetings weekly to review team-wide utilization data, share best practices, and identify and resolve systemic issues. Administer the full performance management lifecycle for all direct reports, including 30/60/90-day onboarding check-ins, semi-annual and annual performance reviews, goal-setting, and performance improvement plans (PIPs) when needed. Recognize and reward high performance through formal and informal channels; escalate and address sustained underperformance in partnership with HR and the Clinical Director. Lead recruitment, interviewing, selection, and onboarding of new team members; partner with HR on offer, compensation, and credentialing processes. Identify individual and team training needs; coordinate role-specific professional development, required CEUs, and compliance training. Foster a positive, accountable, and psychologically safe team culture that supports staff retention and reduces turnover. Maintain accurate personnel records and submit required people-management documentation to HR and leadership on schedule. 2. Billing, Utilization & Quota Ownership Own the team's weekly billable hours quota; ensure every case manager understands their individual target and the team's aggregate goal each week. Monitor daily and weekly utilization data through the company dashboard; proactively identify CMs who are trending below target and intervene in real time. Review the weekly utilization report on its first run to identify billing errors, documentation gaps, and under-billed sessions before the final submission deadline. Ensure that billing for all service codes (H2014 Skills Training, T1017 Routine Case Management, medication management, etc.) reflects actual services delivered and that modifier codes and location codes are entered correctly. Investigate and resolve billing discrepancies, duplicate entries, or missing session records in the electronic health record (EHR/ICANotes) prior to weekly close. Ensure all case managers have accurate available-hours data entered in the system so that utilization rates can be calculated and reported correctly each week. Submit weekly performance data to the company leadership dashboard by the required deadline; present utilization findings and action plans during scheduled leadership reports. Collaborate with the billing department to resolve claim denials, payer-specific documentation requirements, and audit findings in a timely manner. Drive continuous improvement toward the organization's target utilization rate; develop and execute corrective action plans when the team falls below goal. 3. Documentation Compliance & Audit Readiness Ensure all case managers complete session documentation in the EHR within the required timeframe (same-day or within 24 hours per organizational policy). Conduct routine documentation audits on each CM's caseload to verify that service notes, treatment plans, progress notes, and assessments meet payer requirements (Medicaid, managed care organizations, private insurers). Verify that all services billed are supported by a current, signed treatment plan that authorizes the service code and frequency being delivered; flag and correct any gaps before claim submission. Monitor treatment plan renewal dates and authorization expirations for the team's entire caseload; ensure renewals are completed proactively to prevent lapses in billed services. Train and coach case managers on payer-specific documentation standards, including correct use of modifier codes (HA, TF, 95), site/location entries, and medical necessity language. Serve as the team's first line of defense for insurance company audits; gather, organize, and submit requested records within required timelines and ensure documentation fully supports services billed. Identify documentation patterns that increase audit risk (e.g., missing signatures, copy-paste notes, vague medical necessity language) and implement corrective training. Ensure client consent forms, insurance verification, and level-of-care assessments are current and properly filed for every active client on the team's caseload. Maintain a working knowledge of state Medicaid rules, MCO contract requirements, and relevant federal regulations; communicate updates to the team promptly. 4. Program Oversight & Client Services Oversee the development, implementation, and ongoing review of individualized service plans for all clients served by the team. Ensure every client on the team's caseload is receiving the prescribed frequency of services in accordance with their treatment plan; investigate and resolve cases where clients are not being seen. Support case managers in managing complex cases, including crisis intervention, multi-system coordination, and transitions of care. Ensure that all services delivered reflect trauma-informed, culturally responsive, and person-centered principles. Participate in case conferences, peer reviews, and multidisciplinary team meetings to ensure continuity and quality of care. Evaluate program effectiveness through data collection, outcome measurement, and reporting to clinical leadership. Collaborate with the Clinical Director to implement service delivery improvements based on quality data and audit findings. 5. Administrative & Operational Duties Manage CM schedules, caseload assignments, and workload distribution to optimize productivity and ensure equitable staffing across the team. Monitor and report staff attendance, productivity, and schedule adherence; escalate patterns of absenteeism or time-management issues through appropriate channels. Ensure compliance with all state, federal, and organizational policies applicable to case management services. Assist with the onboarding of new clients, including intake coordination, insurance verification, and assignment to appropriate case managers. Maintain accurate and timely records for all administrative reporting requirements. 6. Community Collaboration Build and maintain relationships with community partners, referral sources, and service providers to ensure robust resource networks for clients. Represent Admore at community events, provider meetings, and stakeholder engagements. Advocate for client needs and program resources within the community and with payer organizations. Key Performance Indicators (KPIs) Team Leads will be evaluated on the following metrics, reviewed weekly, monthly, and at each performance cycle: Billing & Utilization Team weekly billable hours: Meet or exceed the team's assigned weekly quota Team utilization rate: Maintain 85-95% of available hours billed (team average) Individual CM utilization: No more than 1-2 CMs below 70% utilization in any given week without documented cause First-run billing error rate: Fewer than 3% of weekly reports contain billing errors on first run Claims denial rate: Team claims denial rate below organizational threshold Documentation & Compliance Same-day/24-hour note completion rate: 95%+ of session notes completed within required timeframe Treatment plan compliance: 100% of active clients have a current, signed treatment plan Authorization currency: Zero lapsed authorizations for active billed clients Audit preparedness: Zero significant findings in routine internal documentation audits; all external audit requests fulfilled within deadline People Management Staff retention: Annual voluntary turnover rate at or below organizational benchmark Performance review completion: 100% of semi-annual and annual reviews completed on schedule Onboarding success: New CMs reach productivity targets within their 90-day ramp period Team engagement: Participation and satisfaction in team supervision sessions; no sustained unresolved team conflicts Client Services Client contact rate: 95%+ of active clients receive at least one billable service contact per week Service plan adherence: All clients receiving services at prescribed frequency per treatment plan Client complaint resolution: All escalated client issues documented and resolved within 5 business days Qualifications Required Bachelor's degree in social work, counseling, psychology, or a related behavioral health field. Current licensure or license-eligible as QMHP-CS, LPC, LCSW, or equivalent in the state of Texas. Minimum 2-3 years of experience in mental health case management or community-based behavioral health services. Demonstrated experience with Medicaid billing, service documentation, and payer compliance requirements. Proven ability to lead, supervise, and develop a team of clinical staff. Proficiency with electronic health records systems (ICANotes or similar). Strong organizational, analytical, and communication skills; ability to interpret and act on utilization data. Preferred 1+ year of supervisory or team lead experience in a behavioral health setting. Experience managing insurance audits, responding to medical record requests, and navigating managed care organization requirements. Bilingual (English/Spanish) strongly preferred. Familiarity with Texas CMBHS and state behavioral health documentation standards. Working Conditions Office-based with regular travel to client homes, community sites, and partner locations required. Standard full-time hours with occasional evening or weekend availability to support staff and client needs. Ability to manage multiple priorities under deadline pressure in a fast-paced, regulated environment. This job description is intended to convey essential functions and requirements and is not an exhaustive list of duties. Admore Behavioral Health reserves the right to modify this description as operational needs change. Job Type:
Full-time Pay:
$55,000.00 per year Benefits:
Paid time off Application Question(s): Are you located in the RGV area? Education:
Bachelor's (Required) Experience:
Mental Health Supervisory:
1 year (Required) License/Certification:
QMHP Certification (Preferred) Work Location:
On the road
