LCM Lead Care Manager Behavioral Health Specialist/LPT/LVN

Lead Care Manager (LCM) Behavioral Health Specialty

Work Location: Field-Based / Hybrid (facility visits, hospital visits, community settings)

Schedule: Monday Friday, 9:00 AM 5:30 PM PST

FTE: Full-Time (40 hours/week)

Payrate: $28/hr

Position Overview

The Lead Care Manager (LCM) Behavioral Health Specialty is responsible for providing high-level care coordination and case management services to Medi-Cal members with complex behavioral health needs under the CalAIM initiative.

This role focuses on members with serious mental illness (SMI), substance use disorders (SUD), cognitive impairment, and co-occurring medical conditions. The LCM ensures members receive appropriate behavioral health services, housing support, and long-term care placement when clinically indicated.

The position requires strong clinical judgment, crisis intervention skills, and the ability to navigate complex systems, including health plans, county behavioral health, and community-based organizations.

Key Responsibilities

• Behavioral Health Case Management
• Manage a caseload of high-acuity members with behavioral health conditions
• Conduct comprehensive assessments including: Psychosocial status, Behavioral health history, Substance use, Functional and cognitive status
• Develop and implement individualized, member-centered care plans
• Coordinate services across: County Behavioral Health Departments, Psychiatrists and therapists, Substance use treatment providers, Primary care and specialists
• Enhanced Care Management (ECM) Delivery
• Deliver all core ECM services in compliance with Enhanced Care Management requirements: Outreach and engagement, Comprehensive assessment and care management, Care coordination, Health promotion, Transitional care, Member and family support, Referral to community and social services
• Ensure timely documentation and service delivery per health plan requirements
• Crisis Intervention & Risk Management
• Identify members at risk for: Psychiatric decompensation, Self-harm or harm to others, Homelessness or housing instability
• Provide immediate intervention and coordination with: Crisis teams, Hospitals, Law enforcement (when necessary)
• Support safe discharge planning from: Acute psychiatric hospitals, Skilled Nursing Facilities (SNFs)
• Placement & Level of Care Coordination
• Evaluate appropriate level of care, including: Medi-Cal members with serious mental health disorders, Board and Care / RCFE, Homeless, instructional
• Collaborate with internal teams for: Housing Navigation, ALT / Community Supports services
• Facilitate transitions and ensure continuity of care
• Interdisciplinary Collaboration
• Work closely with: Health Plans (MCPs), Discharge planners, Social workers, Facility administrators
• Participate in case conferences and utilization reviews
• Advocate for appropriate services and authorizations
• Documentation & Compliance
• Maintain accurate, timely documentation in EMR
• Ensure compliance with: DHCS requirements, Health Plan contracts, CalAIM program standards
• Track outcomes and report barriers to care

Minimum Qualifications

• Bachelor's degree in: Nursing, Social Work, Psychology, or related field
• AND one of the following: LPT/LVN, Social Worker, Behavioral Health Case Management experience (2+ years)

Required Experience

• Minimum 23 years in: Behavioral health case management, Medi-Cal or managed care environment
• Experience with: Serious Mental Illness (SMI), Substance Use Disorders (SUD), Crisis intervention

Core Competencies

• Strong clinical assessment and critical thinking
• Crisis de-escalation and intervention skills
• High-level care coordination and system navigation
• Ability to manage high-volume, fast-paced caseloads
• Excellent communication and documentation skills
• Cultural competency and trauma-informed care approach

Performance Expectations

• Timely member outreach and engagement
• Compliance with ECM timelines and documentation standards
• Effective coordination resulting in: Reduced hospitalizations, Stabilized behavioral health conditions, Successful housing and placement outcomes
• Strong collaboration with internal and external partners

The Significance of This Role

The LCM Behavioral Health Specialty is the frontline stabilizer for your highest-risk members.