Hybrid Social Worker - Care Manager bei EPIC Health

Job Title: Social Worker Care Manager – Collaborative Care Model (CoCM) 

Location: HQ
Department: Care Management / Behavioral Health
Job Type: Full-time 

Position Summary: 

The Behavioral Health Care Manager (BHCM) is a key member of the Collaborative Care Model (CoCM) team, responsible for delivering evidence-based care management services to patients with moderate to severe behavioral health conditions, such as depression, anxiety, bipolar disorder, PTSD, or substance use disorders. Working in close collaboration with primary care providers (PCPs), a psychiatric consultant, and the broader care team, the BHCM helps develop and implement individualized care plans, conduct behavioral assessments, monitor clinical outcomes, and support transitions of care. 

This role is ideal for a licensed social worker (LSW, LLSW, LCSW, LMSW, LLMSW) who thrives in a fast-paced, team-based, integrated care setting. 

Key Responsibilities: 

• Serve as the designated care manager in the Collaborative Care team, partnering with PCPs and psychiatrist.
• Conduct follow-up screenings for behavioral health conditions using validated tools (e.g., PHQ-9, GAD-7, AUDIT-C).
• Develop, implement, and regularly update patient-centered care plans aligned with treatment goals.
• Provide brief, evidence-based interventions (e.g., behavioral activation, problem-solving therapy, motivational interviewing) via phone, video, or in-person.
• Track patient progress using a behavioral health registry and adjust interventions as needed to achieve clinical improvement.
• Coordinate referrals to specialty mental health, substance use treatment, or community-based services when needed.
• Facilitate weekly case conferences with psychiatrist on patients not improving and implement recommendations in collaboration with the PCP.
• Monitor adherence to treatment, including medication and therapy engagement, and help address barriers to care.
• Maintain accurate, timely documentation in the EHR per CoCM and billing guidelines.
• Collaborate with care team members to support patients with social determinants of health impacting behavioral health (e.g., housing instability, trauma, transportation).
• Participate in ongoing quality improvement and program development efforts.

Qualifications: 

• Education: Bachelor’s or Master’s degree in social work from an accredited institution required.
• Licensure: Active LSW, LLSW, or equivalent in the state of Michigan; full licensure preferred.
• Experience:
  • 2+ years of experience in mental health, behavioral health, or integrated care setting preferred.
  • Experience with behavioral health screenings, brief interventions, and care planning required.
  • Familiarity with CoCM or other team-based care models preferred.

Required Skills and Competencies: 

• Strong understanding of common behavioral health diagnoses and evidence-based treatment approaches.
• Excellent written and verbal communication skills.
• Proficient with EHR documentation and behavioral health registries (or willingness to learn).
• Ability to work both independently and collaboratively in a multidisciplinary team.
• Compassionate, nonjudgmental approach to care, with sensitivity to diverse populations.
• Ability to maintain professional boundaries and always uphold patient confidentiality.

Preferred Certifications/Training: 

• Training or certification in Collaborative Care, Problem-Solving Therapy, or other brief intervention models a plus.
• Trauma-informed care and/or motivational interviewing experience.

Schedule & Location: 

• Monday through Friday: 8-hour shift (with some flexibility).

Compensation & Benefits: 

• Competitive salary commensurate with experience.
• Health, dental, and vision insurance.
• Paid time off and holidays.
• Clinical supervision (if applicable).
• Continuing education allowance and professional development support.

Equal Opportunity Employer Statement: 

EPIC Health is an Equal Opportunity Employer and values diversity at all levels of the workforce. We encourage applications from all qualified individuals, regardless of race, religion, gender, sexual orientation, age, or disability.