BH Case Manager

Job Description

Job Description

I shortened the approved description too much. Here is a job posting that keeps its original wording and qualifications much closer to the source:

St. John’s Community Health
Department: Programs – CalAIM, ECM
FLSA Status: Exempt
Reports to: ECM IE Program Manager and Director of CalAIM

St. John’s Community Health is committed to eliminating health disparities and supporting community well-being through high-quality care in Los Angeles, San Bernardino, and Riverside Counties.

The Behavioral Health Care Manager for the Enhanced Care Management (ECM) program provides comprehensive care management, behavioral health interventions, crisis support, care coordination, and member advocacy. This role supports individuals with serious mental illness (SMI), substance use disorders (SUD), and complex medical and behavioral health needs.

The Behavioral Health Care Manager partners with primary care providers, behavioral health specialists, hospitals, community-based organizations, and interdisciplinary care team members to improve access to services, coordinate transitions of care, and promote positive health outcomes. The role also provides member and family education, tracks clinical outcomes, develops person-centered Shared Care Plans, and helps members build greater self-management, wellness, and independence.

• Manage a diverse caseload of members with serious mental illness, substance use disorders, and complex medical, behavioral health, and social service needs.

• Conduct outreach, assessment, and enrollment activities to engage eligible members in ECM.

• Provide evidence-based behavioral health interventions, motivational interviewing, behavioral activation, crisis intervention, safety planning, and therapeutic support.

• Develop, implement, and monitor individualized Shared Care Plans that address medical, behavioral health, housing, and social needs while aligning with member goals and provider recommendations.

• Coordinate care with primary care providers, behavioral health professionals, specialists, hospitals, managed care plans, community-based organizations, and social service agencies.

• Support transitions of care by coordinating hospital admissions, discharges, referrals, follow-up appointments, and connections to community resources.

• Educate members and families on medical and behavioral health conditions, treatment options, community resources, and self-management strategies.

• Lead and participate in multidisciplinary team meetings, case conferences, and care reviews.

• Maintain knowledge of community resources, housing services, supportive programs, and referral networks.

• Provide guidance, mentorship, and clinical support to care team staff in collaboration with ECM leadership.

• Complete accurate and timely documentation in eClinicalWorks and other required systems, including care plans, progress notes, and assessments.

• Review member charts and documentation for compliance with managed care contracts, quality standards, and organizational policies.

• Monitor program performance and quality metrics and identify opportunities to improve member outcomes.

• Collaborate with ECM Registered Nurses, Program Managers, and interdisciplinary teams to integrate care management into clinical workflows.

• Participate in training, meetings, community events, and other organizational initiatives.

• Three or more years of experience in behavioral health, care management, case management, population health, or integrated care settings.

• Experience serving individuals with serious mental illness, substance use disorders, homelessness, chronic medical conditions, and other complex psychosocial needs.

• Knowledge of CalAIM, ECM, Community Supports, Medi-Cal managed care programs, and social determinants of health.

• Skills in crisis intervention, care coordination, care planning, patient engagement, motivational interviewing, and multidisciplinary collaboration.

• Experience using electronic health records and documenting care management activities.

• Strong organizational, communication, and relationship-building skills.

Preferred qualifications:

• Master’s degree in social work, counseling, psychology, public health, nursing, or a related field.

• Active California ACSW, LCSW, AMFT, LMFT, APCC, LPCC, RN, or equivalent licensure or registration.

• Bilingual English and Spanish skills, including reading, writing, and speaking.

• CPR/First Aid certification, Certified Case Manager certification, or motivational interviewing training.

A valid California driver’s license, reliable transportation, and the ability to drive and travel by car as needed are required.

St. John’s Community Health is an Equal Employment Opportunity Employer. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.