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Clinical Care Management Specialist
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- The Clinical Care Manager is responsible for utilization management by conducting utilization review activities, population management, cross-system consultation, provider management and treatment quality monitoring.
- The Clinical Care Manager must utilize clinical knowledge of best practices and evidence based treatments to ensure CBH members receive timely access to quality, medically necessary behavioral health services.
- When clinically indicated, Clinical Care Managers consult with CBH Physician and Psychologist Advisors to ensure the most effective treatment for the CBH member is being authorized.
- Complete Utilization Management activities including but not limited to: interagency meetings, social determinants interviews with members, treatment team meetings, case consultations, care coordination, provider meetings, reviews, treatment linkage.
- Collaborate with other CBH departments to ensure quality of care, promote placement of members in the most appropriate services and to facilitate consistent longitudinal care management.
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