Case Monitor

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Job Title:
Case Monitor
Reports to:
Clinic Manager

Summary:

The Case Monitor serves as a dedicated point of contact for all new intakes and clients enrolled in medication management (MM)-only services at Alliance Healthcare Services’ outpatient clinics. This position bridges administrative and clinical engagement functions, ensuring that MM-only clients remain connected to all appropriate services and have all required chart updates, serves as the contact for all intakes, and complete all Patient Assistance Program (PAP) needs.

None.

Bachelor’s degree or higher in Psychology, Social Work, Counseling, Healthcare Administration, or a related health or human services field required.

None.

Minimum of two (2) years of experience in healthcare, behavioral health, case management, care coordination, or a related field preferred. Must demonstrate strong organizational skills, communication skills, attention to detail, and the ability to effectively coordinate multiple client needs and priorities simultaneously.

• Coordinate and complete the full intake process for new clients, including gathering and recording information, obtaining required forms, and preparing charts in Credible.
• Schedule appointments after intake and coordinate the intake flow for their clinic.
• Conduct follow‑up calls regarding intakes, incomplete paperwork, or missing documentation.
• Complete intake treatment plans and documentation in Credible within agency‑established time frames.

• Run and verify insurance eligibility for all assigned clients using applicable systems; update payor sources in Credible.
• Identify and resolve insurance issues, including expired or inactive coverage, out‑of‑network plans, and billing discrepancies, escalating to appropriate staff as needed.
• Assist clients with completing Behavioral Health Safety Net (BHSN) applications and enrollment.
• Set up and document self‑pay arrangements in accordance with agency policy.
• Assist with out‑of‑network insurance referrals and plan‑to‑plan transitions.
• Complete NOMS administrative discharges and other payer‑required administrative tasks as assigned.

• Maintain an active caseload of MM‑only clients; conduct regular outreach to monitor engagement, identify barriers to care, and support continued attendance at medication management appointments.
• Assess client readiness and interest in transitioning to additional treatment interventions, including therapy, care coordination, or other outpatient services; facilitate warm handoffs and internal referrals as appropriate.
• Alert the Clinical Manager to clients who are disengaging, declining services, or presenting with elevated clinical concerns requiring provider or supervisor review.
• Contact clients and families to provide appointment reminders and follow‑up communication regarding MM appointments, as necessary.
• Coordinate telehealth appointment setup for MM clients receiving services remotely, including technical assistance as needed.
• Maintain accurate scheduling records and document all appointment activity in Credible in accordance with agency and payer expectations.

• Provide face‑to‑face (primary) and phone (secondary) person‑centered care coordination services in accordance with current Behavioral Health Safety Net (BHSN), Tennessee Health Link (THL), payer, and agency expectations.
• Coordinate services with medical providers, behavioral health providers, clients, families, caregivers, and internal treatment teams to support continuity of care.
• Educate and support clients in promoting both mental and physical health goals.
• Provide transitional care coordination and high‑touch support during crisis situations or significant care transitions, including hospitalizations and emergency room visits.
• Participate in discharge planning after hospitalization…