About the position

As a LTSS Service Care Manager for Behavioral Health at Superior HealthPlan, you will play a crucial role in transforming the health of our communities by providing holistic care management activities focused on populations with significant mental and behavioral health needs. Your primary responsibility will be to evaluate member service needs and develop or contribute to the development of care plans and service plans. You will educate members, their families, and caregivers about the services and benefits available to meet their needs. This position requires you to assess the needs of complex and high-risk members, recommend plans of care, and act as a liaison and advocate between members, families, physicians, and facilities/agencies. In this role, you will support members with various mental and behavioral health conditions, including major depression, bipolar disorders, schizophrenia, and substance use disorders. You will perform frequent home and site visits to assess member needs and collaborate with resources. Additionally, you will provide education to long-term care members and their families on preventive care, treatment options, and healthcare benefits. Your expertise will also be utilized in handling crisis calls, providing mental health first aid training, and monitoring medication treatment regimens. You will coordinate community resources, ensuring that identified services are accessible to members, and maintain accurate documentation in the electronic care management system. Compliance with clinical guidelines and state and federal regulations is essential, and you will provide feedback to leadership on opportunities to enhance the quality of care and service delivery. This position requires travel throughout North Dallas for member visits and the ability to work independently with minimal supervision.

Responsibilities

• Develop, assess, and coordinate holistic care management activities for members with significant mental/behavioral health needs.
• Evaluate member service needs and contribute to the development of care plans/service plans.
• Educate members, families, and caregivers on available services and benefits.
• Assess the needs of complex and high-risk members and recommend plans of care.
• Act as a liaison and member advocate between members, families, physicians, and facilities/agencies.
• Perform frequent home and/or site visits to assess member needs and collaborate with resources.
• Provide education to long-term care members and their families on preventive care and treatment options.
• Provide subject matter expertise for mental and behavioral health-focused activities.
• Coordinate community resources, including medical, behavioral, and social services.
• Ensure appropriate referrals based on individual member needs and support the identification of providers and community resources.
• Maintain accurate documentation in the electronic care management system.
• Ensure compliance with clinical guidelines and state and federal regulations.
• Provide feedback to leadership on opportunities to improve quality of care and service delivery.

Requirements

• Master's degree in Mental Health or Social Work or Graduate from an Accredited School of Nursing.
• 2 - 4 years of related experience in behavioral health or case management.
• Licensed Behavioral Health Professional or RN with psychiatric experience (LCSW, LPC, or RN with BH experience).
• Strong clinical documentation skills and ability to utilize case management systems.
• Proficient computer skills with Microsoft and video conferencing applications.

Nice-to-haves

• 3+ years of case management experience with the adult population with serious mental illness and behavioral health conditions.
• 3+ years of experience in patient advocacy or coordinating community mental health services.
• Experience working in in-patient/out-patient facilities or community-based Behavioral Health settings.
• Experience administering psychological assessments and managing high volume caseloads.
• Bilingual in Spanish and English.

Benefits

• Health insurance
• 401(k)
• Tuition reimbursement
• Paid time off
• Flexible work schedules (remote, hybrid, field, or office work)