The Targeted Case Manager (TCM) is responsible for coordinating, advocating for, and monitoring services for individuals with behavioral health needs. The TCM works collaboratively with clients, families, providers, and community agencies to ensure clients receive medically necessary services that promote recovery, independence, and overall well-being while maintaining compliance with AHCA, Medicaid, and organizational standards.
Essential Job DutiesCase Management Services
- Conduct comprehensive biopsychosocial and needs assessments.
- Develop individualized Targeted Case Management Care Plans based on client needs.
- Coordinate medical, behavioral health, psychiatric, and social services.
- Assist clients in obtaining community resources, including:
- Housing
- Food assistance
- Transportation
- Employment resources
- Financial assistance
- Educational services
- Social Security/Disability benefits
- Advocate on behalf of clients to ensure access to medically necessary services.
- Coordinate referrals and follow up to ensure services are received.
- Assist clients with appointment scheduling and treatment adherence.
- Monitor client progress and update care plans as needed.
Documentation
- Complete all documentation within required timeframes.
- Maintain accurate, complete, and timely clinical records.
- Document all client contacts in accordance with Medicaid and organizational requirements.
- Maintain compliance with AHCA documentation standards.
- Ensure all case notes support medical necessity.
- Complete monthly and annual reassessments as required.
Care Coordination
- Communicate with psychiatrists, therapists, medical providers, and community partners.
- Participate in interdisciplinary treatment team meetings.
- Collaborate with family members and caregivers when appropriate.
- Assist with discharge planning and continuity of care.
Crisis Intervention
- Respond appropriately to behavioral health crises.
- Assist clients with safety planning.
- Coordinate emergency services when necessary.
- Notify supervisors of any reportable incidents.
Compliance
- Maintain HIPAA confidentiality.
- Follow all AHCA, Medicaid, and organizational policies.
- Maintain current required certifications and trainings.
- Report suspected abuse, neglect, or exploitation according to Florida law.
- Adhere to all documentation and billing regulations.
Quality Assurance
- Participate in internal audits and quality improvement activities.
- Correct documentation deficiencies promptly.
- Maintain productivity expectations established by the clinic.
- Attend mandatory staff meetings and trainings.
Administrative Duties
- Maintain organized client files.
- Monitor authorizations and service expirations.
- Assist with appointment reminders.
- Track referrals and outcomes.
- Complete additional duties assigned by the supervisor.
Required Qualifications
- Bachelor's degree in Social Work, Psychology, Human Services, Counseling, or a related field (or as required by Florida Medicaid and program guidelines).
- Experience in behavioral health or case management preferred.
- Knowledge of community resources.
- Excellent communication and organizational skills.
- Ability to work independently and as part of a multidisciplinary team.
- Valid Florida driver's license and reliable transportation (if travel is required).
Pay: $28.00 - $30.00 per hour
Work Location: In person
