Hybrid Clinical Care Manager, LICSW/LMHC

at CareSource

• Job title: Clinical Care Manager, LICSW/LMHC
• Job type: Full Time
• Experience level: Junior
• Salary: $90,000 - $120,000 per year
• Degree requirement: High School Diploma
• Location requirements: Hybrid, Lowell, United States

About the role

• Care Navigator managing telephonic interactions and supporting service coordination for CareSource members. Conducting outreach and collaborating across providers and care teams to enhance member satisfaction.

Responsibilities

• Conducts outreach to members and providers to confirm service details, coordinate scheduling, address general inquiries, and ensure accurate documentation of care coordination activities.
• Coordinate services by working with providers, community partners, and member/caregivers to manage scheduling, service updates, and administrative changes, as needed.
• Serves as a support resource for member and provider requests, escalations, or concerns by coordinating responses and ensuring issues are routed or addressed promptly.
• Collaborates with the care team, providers, and other partners as needed to support member service requests and ensure smooth communication and continuity across care activities.
• Initiate outreach to members, vendors, providers, and/or vendors/suppliers to follow up on non-clinical matters assigned by the Care Team (e.g., including authorization status, DME status, appointment scheduling and prescription assistance).
• Provide administrative support as assigned.
• Assist members and the Care Team with solving health plan related concerns, i.e. claims follow up or prior auth status, etc.
• Help members schedule transportation to medical appointments; assist members with booking issues.
• Support targeted member outreach campaigns when there is an event that has the potential to broadly impact our membership’s wellness, such as agency closures, hazardous/catastrophic events (e.g., power outages, fires, inundations).
• Coordinates interpreting and translation supporting services for the member (including ADA compliance).
• Obtain documents/forms that allow Care Team to speak with members and/or representatives on the member’s behalf in accordance with HIPAA laws – e.g., Release of Information (ROI), Oral Disclosure of Protected Health Information.
• Assist leadership with the development, refinement and enhancement of programs, initiatives, processes, policies, workflows, and projects.
• Mentor for new Care Navigation Specialist – during and beyond their orientation period, if needed.
• Maintain accurate documentation and maintenance of member records and alignment with regulatory standards, ensuring timely distribution to appropriate internal teams or provider partners as needed.
• Follow established standards of practice, internal policies, and procedures to ensure compliance with contractual obligations and applicable regulatory requirements.
• Identify member and provider needs and facilitates referrals to appropriate internal teams such as care management or community-based support programs.
• Performs any other job related duties as requested.

Requirements

• High School or GED required
• One (1) year of related experience in a health-related service field required
• Critical thinking and troubleshooting skills
• Strong customer service and problem-solving skills
• Ability to work in multiple systems, often simultaneously
• Clear, concise, and effective oral and written communication
• Strong time management and demonstrated ability to work independently
• Flexibility to adapt to business needs
• Motivated team player
• Excellent organizational skills
• High attention to detail and accuracy
• Basic arithmetic skills required
• Proficiency in Microsoft Office Suite

Benefits

• Health insurance
• Retirement plans
• Paid time off
• Flexible work arrangements
• Professional development
• Bonuses