Behavioral Health Care Management Clinician, Consultant (Lead)

Company: Blue Shield of California
Location: San Diego
Posted on: May 27, 2025

Job Description:

Your Role Reporting to the Manager, Care Management- Behavioral Health, the Behavioral Health Care Management Clinician, Consultant (Lead) is a team lead for a team of Behavioral Health Care Managers. The Behavioral Health Care Management Team helps members with behavioral health needs navigate the health care system for linkages to behavioral health providers, treatment, and programs. The Behavioral Health Care Managers offer support in assessing members' emotional and psychological well-being and providing resource coordination, crisis intervention, substance abuse, and with any behavioral or mental health referrals. The Behavioral Health Care Managers will be available to physicians and nurse care managers as consultants for patients with complex psychosocial needs. The position requires an intensive focus on crisis intervention and counseling, problem-solving and conflict resolution, patient and family management, interdisciplinary collaboration, psychosocial assessments, education, advocacy, and community resource linkages.Your Work In this role, you will:

• Act in a leadership role as a lead Care Manager - addresses line staff questions and issues and escalate to management with recommendations or consultation as needed
• Lead onboarding/training of incoming staff, provide proactive and guided support through the onboarding process
• Maintain and gain knowledge of behavioral health care management through team and departmental expansion as needed
• Act as subject matter expert to review and evaluate the effectiveness of operational workflows to identify problems and develop improvements, modifications, and enhancements
• Develop and evaluate tools and materials that enhance operating efficiency, accuracy, and technical skill levels of unit staff
• Assist with audit readiness in collaboration with internal BSC partners
• Provide consultation and guidance on escalated or high complexity member concerns.
• Identify process and control improvement opportunities and provide recommendations that help improve the effectiveness, efficiency and/or economic value of a control or process
• Provide guidance, coaching and training on internal behavioral health care management processes to other employees across the company as appropriate
• Lead, manage, and execute other special projects and team initiatives as assigned
• Lead team huddles/meetings to support processes and collaboration of team member
• Support team through consistent and successful caseload management and workload to achieve team goals, regulatory timelines, and accreditation standards Your Knowledge and Experience
  • Current unrestricted CA license (LCSW, LMFT, LPCC, PhD/PsyD or RN with Behavioral Health experience) required
  • Advanced degree commensurate with field is preferred
  • Requires at least seven (7) years of prior relevant experience including 3 years of experience in behavioral health.
  • Certified Case Manager preferred
  • Previous experience in a lead or leadership role or demonstrated mastery of case management principles through hands on experience with successful outcomes.
  • Possess excellent interpersonal, organizational, and communication skills, positive attitude, and high level of initiative
  • Ability to identify problems and work towards problem resolution independently, seeking guidance as needed
  • Experience conducting thorough psychosocial assessments, developing care plans and providing necessary interventions identified during assessment with complex client populations that may have, among other things, inadequate coping skills, severe emotional disorders, developmental disabilities, mental illnesses, and/or unstable housing
  • Considerable knowledge of a wide range of psychosocial challenges and familiarity with behavioral health diagnoses and treatment
  • Proficient with computer programs such as Microsoft Excel, Outlook, Word, and PowerPoint

Keywords: Blue Shield of California, San Clemente , Behavioral Health Care Management Clinician, Consultant (Lead), Executive , San Diego, California