Clinical Care Manager

Clinical Care Manager oversees longitudinal care management for members with complex behavioral health needs across residential and community settings, ensuring clinically appropriate, person-centered care through utilization management, collaboration with providers and system partners, and discharge planning. Responsibilities include applying behavioral health systems and medical necessity criteria, coordinating with members and natural supports, ensuring evidence-based treatment planning, conducting 8-15 UM activities per day within the Specialty Populations Care Management Team, reviewing referrals for residential levels of care, facilitating transitions to lower levels of care when appropriate, and engaging with members and providers onsite at provider locations. Required qualifications include a Master’s degree in Social Work or related clinical field, Pennsylvania Child Abuse Clearance, licensure (LSW/LPC/LMFT/LCSW) or progression towards licensure within 18 months, and minimum 3 years of direct clinical care experience with adults, children, and/or families in behavioral health; strong communication, collaboration, and organizational skills; HIPAA compliance; and a Philadelphia residency requirement. Equal opportunity employer committed to diversity and inclusion.