Job Description

The Transitional Case Management (TCM) Specialist provides outreach, engagement, and care coordination services to support continuity of care for individuals enrolled in Managed Care Organization (MCO) plans who are at risk of disengagement from behavioral health treatment services. This role is responsible for identifying clients who have not participated in qualifying clinical services within required timeframes, conducting outreach and supportive intervention, documenting Targeted Case Management services in accordance with Medicaid and agency standards, and communicating identified clinical concerns to program leadership.

The TCM Specialist works collaboratively with Adult Services, Children’s Services, clinical providers, case managers, and revenue cycle leadership to support service continuity, client engagement, regulatory compliance, and appropriate reimbursement practices consistent with CMHC and He-M standards.

KEY RESPONSIBILITIES

1. Client Outreach, Engagement & Continuity of Care
2. Therapeutic Support & Case Management Services
3. Documentation, Compliance & Quality Assurance
4. Collaboration & Team Participation

Requirements

MINIMUM QUALIFICATIONS

• Education: Bachelor’s degree in social work, psychology, counseling, rehabilitation, human services, or related field.
• Experience:
  • Minimum of one (1) year experience working with individuals with behavioral health needs, including children, families, or adults.
  • Experience with outreach, care coordination, advocacy, or case management functions.
• Skills:
  • Strong communication, organizational, and interpersonal skills.
  • Ability to work collaboratively within a multidisciplinary team.
  • Proficiency with electronic medical record systems and basic computer applications.

PREFERRED QUALIFICATIONS

• Experience working within a Community Mental Health Center (CMHC).
• Knowledge of Medicaid Targeted Case Management requirements and He-M standards.
• Experience working with Serious Emotional Disturbance (SED), Serious Mental Illness (SMI), or co-occurring disorders.
• Familiarity with managed care processes and behavioral health documentation requirements.
• Experience coordinating care with schools, hospitals, and community agencies.

OTHER EXPECTATIONS

• Maintain a valid driver’s license, acceptable driving record, reliable transportation, and proof of automobile insurance.
• Transport clients when required and appropriate in accordance with agency policy.
• Maintain flexibility in scheduling based on program and client needs.
• Participate in agency committees, initiatives, and trainings as assigned.
• Demonstrate commitment to recovery-oriented and trauma-informed care principles.