Nurse Case Manager / Behavioral Health Case Manager
Location: 100% Remote – Must Reside in Specified Michigan Counties
Hours: Monday – Friday, 8 AM – 5 PM (40 hrs/week)
Required Residence – Michigan OnlyCandidate MUST reside in one of these Michigan counties:
Berrien, Van Buren, Cass, Kalamazoo, St. Joseph, Calhoun, Branch, Jackson, Hillsdale, Livingston, Washtenaw, Lenawee, Monroe, Oakland, Macomb, Wayne, Clinton, Eaton, Ingham
Position SummaryThe Behavioral Health Case Manager is responsible for performing comprehensive telephonic assessments, care planning, and ongoing case management for members enrolled in health plans. This role focuses on behavioral health support, quality-of-care improvement, and coordinating services to achieve optimal, cost-effective outcomes.
Key ResponsibilitiesMember Assessment & Care PlanningConduct comprehensive member assessments using clinical tools and data review.
Evaluate benefit plans, eligibility, and available internal/external resources.
Develop individualized care plans and strategies to address behavioral and medical needs.
Perform crisis intervention and ensure appropriate follow-up care.
Clinical Collaboration & Care CoordinationApply clinical judgment to reduce risk factors and support behavioral health needs.
Consult with Medical Directors, supervisors, and interdisciplinary teams as needed.
Identify and escalate quality-of-care issues.
Coach members using motivational interviewing techniques to promote lifestyle changes.
Monitoring, Documentation & ComplianceMonitor care plan progress and adjust plans based on member needs.
Document all interactions and clinical decisions in case management systems.
Maintain compliance with regulatory standards, accreditation requirements, and company policies.
Required QualificationsMinimum Master's Degree in Behavioral Health, Mental Health, Social Work, or Human Services.
Active, unrestricted Michigan license:
3+ years clinical experience in hospital, outpatient, ambulatory, or similar settings.
Experience in healthcare or managed care environments.
Strong computer proficiency (multiple systems navigation, documentation accuracy).
Excellent verbal and written communication skills.
Ability to work in a fast-paced, high-volume environment and manage multiple priorities.
Preferred QualificationsCCM Certification (Certified Case Manager)
Behavioral Health case management experience
Crisis intervention experience