Role Description
This role involves utilizing your clinical expertise to help guide members through complex health journeys and ensure they receive the care and support they need.
• Leverage advanced clinical judgment and critical thinking to assess member needs
• Develop care plans and coordinate with providers
• Connect individuals to psychosocial wraparound services
• Promote effective resource utilization and drive optimal, cost-effective health outcomes
Key Responsibilities
• Conduct comprehensive assessments using clinical tools and data to determine member needs and eligibility
• Evaluate benefit plans and available resources to guide care planning
• Apply clinical strategies to reduce risk factors and address complex health indicators
• Provide crisis intervention and follow-up to ensure members receive appropriate behavioral and medical care
• Collaborate with providers and internal teams to develop and monitor personalized care plans
• Use motivational interviewing to engage members in their health journey and promote lifestyle changes
• Identify and escalate quality-of-care concerns through established channels
• Ensure compliance with regulatory and accreditation standards
Qualifications
• Master’s degree in Behavioral/Mental Health or related field (e.g., Social Work, Counseling, Psychology)
• Active, unrestricted independent clinical license in your state: LCSW, LISW, LCPC, LP, LMFT, LMHC
• 3+ years of post-master’s clinical experience in hospital, outpatient, or ambulatory settings
• 3+ years of experience in behavioral health and substance use disorder care
• Strong communication skills with the ability to manage crisis calls and multitask (talk and type simultaneously)
• Proficiency in motivational interviewing and technology platforms
Preferred Qualifications
• Crisis intervention experience
• Background in managed care or utilization review
• Experience in case management and discharge planning
Benefits
• 100% Remote: Work from your home - anywhere in the U.S.
• Work-Life Balance: No nights, weekends, or holidays
• Collaborative Culture: Partner with experienced clinicians and medical directors
• Purpose-Driven Work: Help members navigate complex health challenges
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation, and weight management programs
• Confidential counseling and financial coaching
• Benefit solutions that address the different needs and preferences of our colleagues
• Paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access, and many other benefits depending on eligibility