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Job Description
GENERAL SUMMARY OF DUTIES
The Behavioral Health Care Manager coordinates and manages care for patients with behavioral health conditions, including mental health and substance use disorders. This position collaborates with behavioral health providers, psychiatrists, primary care providers, care coordinators, patients, families, and community partners to develop, implement, monitor, and update individualized care plans. The Behavioral Health Care Manager ensures patients receive appropriate behavioral health services through care coordination, referrals, crisis support, follow-up services, patient education, and outreach efforts designed to improve health outcomes and quality of life. The Behavioral Health Care Manager serves as a liaison between patients, providers, schools, hospitals, community agencies, and support systems to address behavioral health needs, barriers to treatment, social determinants of health, and continuity of care. The position supports organizational compliance with Joint Commission standards, Patient-Centered Medical Home (PCMH) requirements, state and federal regulations, and evidence-based behavioral health practices.
SUPERVISION EXERCISED
None
ESSENTIAL FUNCTIONS
Conduct mental health assessments utilizing PHQ-2, PHQ-9, and other evidence-based screening tools approved by the organization. Practices and maintains compliance with all federal, state, and local regulations, guidelines, protocols, and standards of care to ensure continuity and quality of patient care. Institutes the principles of Joint Commission and Patient-Centered Medical Home (PCMH) models, utilizing clinical protocols and tracking tools under the direction of clinical leadership. Develops, implements, and maintains individualized behavioral health care plans in collaboration with behavioral health providers, patients, and families. Coordinates care for patients with depression, anxiety, trauma-related disorders, substance use disorders, serious mental illness, and other behavioral health conditions. Reviews and updates behavioral health care plans at established intervals and whenever there is a significant change in the patient's condition. Monitors patient progress toward behavioral health treatment goals and documents outcomes in the Electronic Medical Record (EMR) in accordance with organizational standards. Ensures HIPAA compliance, patient confidentiality, and adherence to all applicable regulatory requirements. Stays informed about new developments in behavioral health services, treatment modalities, and referral processes. Provides education and resources to patients, families, and healthcare staff as needed. Conducts patient follow-up activities to reduce missed appointments and improve patient engagement and continuity of care. Participates in quality improvement initiatives related to behavioral health outcomes, patient engagement, access to care, and care coordination. Tracks and reports behavioral health quality measures and performance indicators on a monthly basis and escalates concerns or trends to the Director of Behavioral Health. Participates in chart audits, compliance reviews, and accreditation readiness activities. Assesses anxiety and depression screening completion rates and remission rates to ensure appropriate follow-up, scheduling, and continuity of care. Collaborates with hospitals, emergency departments, schools, community agencies, and specialty providers to facilitate transitions of care. Assists patients in overcoming barriers to treatment, including transportation, financial limitations, social determinants of health, and access to community resources. Facilitates case conferences and interdisciplinary meetings for patients with complex behavioral health needs. Assesses and monitors patients for suicide risk, self-harm risk, substance use concerns, and other behavioral health crises in accordance with approved screening tools, organizational protocols, and established standards of care. Ensures appropriate safety planning, crisis intervention, referrals, and follow-up services when clinically indicated and escalates high-risk patients to licensed behavioral health providers and/or the Director of Behavioral Health in accordance with organizational protocols. Maintains competency-based training related to suicide prevention, crisis intervention, de-escalation techniques, risk assessment, and behavioral health emergency response. Conducts outreach and follow-up for patients identified as high-risk or who have missed behavioral health appointments. Performs other duties as assigned.
QUALIFICATIONS
To perform this job successfully, an individual must be knowledgeable of modern office methods, procedures, equipment and business writing skills; practices and terminology used in clinical, clerical, medical settings and electronic medical records. Knowledgeable methods, practices, principles and terminology used in behavioral health settings. The individual must possess knowledge of behavioral health care coordination, patient engagement strategies, care planning, healthcare compliance standards, and community resource navigation. The individual must demonstrate strong organizational, communication, critical thinking, and problem-solving skills while maintaining professionalism and confidentiality.
EDUCATION AND EXPERIENCE
Required Bachelor's degree in social work, Psychology, Counseling, Public Health, Human Services, Behavioral Sciences, or a related field. Minimum of three (3) years of experience in healthcare, behavioral health, care coordination, case management, community-based services, or related patient service environments. Experience working with individuals experiencing mental health conditions, substance use disorders, and psychosocial barriers to care. Preferred Master's degree in social work, Counseling, Psychology, Behavioral Sciences, Public Health, or related field. Experience working within a Federally Qualified Health Center (FQHC), integrated care setting, or community behavioral health environment. Experience with Joint Commission standards, PCMH requirements, quality improvement initiatives, and healthcare compliance programs.
KNOWLEDGE, SKILLS, AND ABILITIES
Knowledge of behavioral health care coordination principles and evidence-based practices. Ability to develop, implement, monitor, and evaluate individualized care plans. Knowledge of behavioral health screening and assessment tools. Knowledge of suicide prevention, crisis intervention. Strong de-escalation techniques, and risk assessment protocols. Strong patient engagement, motivational interviewing, and communication skills. Ability to establish effective working relationships with patients, families, providers, and community partners. Ability to analyze data, identify trends, and recommend performance improvement opportunities. Ability to maintain confidentiality and exercise sound judgment in sensitive situations. Strong organizational skills with the ability to prioritize multiple assignments and meet deadlines. Proficiency with Electronic Medical Records (EMR), Microsoft Office applications, and healthcare technology systems. Demonstrated cultural competency and ability to work effectively with diverse patient populations. Ability to travel between clinic locations and attend local, regional, or statewide meetings and training as needed.
LANGUAGE SKILLS
Ability to read, write, speak, and comprehend English fluently. Bilingual abilities are preferred but not required.
CERTIFICATIONS
Current CPR/BLS Certification required. Additional behavioral health or care management certifications are preferred.
COGNITIVE REQUIREMENTS
Ability to assess, analyze, and prioritize patient needs. Ability to recognize behavioral health crises and determine appropriate escalation procedures. Ability to exercise independent judgment within established policies and procedures. Ability to make sound decisions in stressful or time-sensitive situations. Ability to maintain attention to detail and accuracy in documentation and reporting.
PHYSICAL DEMANDS
The employee is regularly required to sit, stand, walk, reach with hands and arms, use hands and fingers to handle objects, and communicate effectively with others. The employee may occasionally lift and/or move items weighing up to 20 pounds. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the position.
