Fallon Health · 1 day ago
ACO Behavioral Health Case Manager - Remote
United States
Full-time
Remote
Mid, Senior Level
4+ years expFallon Health is a mission-driven not-for-profit health care services organization based in Worcester, Massachusetts. They are seeking an ACO Behavioral Health Case Manager I to support care coordination and management for ACO members, focusing on improving access to quality care through assessments and individualized care plans.
WellnessHealthcareFitnessHealth CareMedical
Responsibilities
Telephonic and in-home assessments; create individualized care plans with members and care teams
Perform care transition assessments and maintain knowledge of program benefits and policies
Educate members/caregivers on disease management and self-care
Advocate for members to access benefits and community resources (e.g., housing, food, transportation)
Develop member-centered care plans and monitor progress toward goals
Coordinate with Nurse Case Managers, Navigators, Social Care Managers, and community partners
Foster relationships with members, families, and providers to ensure timely, cost-effective care
Participate in clinical rounds and report safety concerns to Protective Services as needed
Attend care plan meetings and provider visits, lead reviews when applicable
Complete assessments, notes, and care plans in TruCare and EMR systems
Serve as a behavioral health consultant and provide training as needed
Collaborate with Fallon Health, Beacon Health Options, and contracted providers to ensure timely mental health and substance use supports
Maintain HIPAA compliance and attend required meetings and supervision
Support quality initiatives and department projects
Cover assignments as needed and perform other duties as directed
Qualification
Required
Master's degree from an accredited school of social work, mental health counseling, psychology
LCSW, Master's MA/MS in Mental Health Counseling – under clinical supervision
Satisfactory Criminal Offender Record Information (CORI) results
Four + years clinical experience in the behavioral health/mental health setting required
Ability to conduct behavioral health assessments, develop and implement comprehensive care plans that addresses the member's behavioral health needs in conjunction with their medical needs and social determinants of health
Ability to serve as a member on an interdisciplinary care team that may include the member's primary care physician, medical providers, behavioral health providers, state agencies and/or internal nurse case managers and navigators
Ability to screen and assist members with social determinants of health including but not limited to relevant food, housing and state applications (e.g., DDS, DYS, DCF, DMH)
Effective case management, care coordination, and member advocacy skills
Knowledge about behavioral health community resources, levels of care, and criteria for levels of care
Familiarity with motivational interviewing and harm reduction to engage and connect with members
Ability to work collaboratively with BH vendor
Familiarity with software systems including but not limited to Microsoft Office Products – Excel, Outlook, and Word
Preferred
Certification in Case Management a plus
Experience with government programs, community resources, case management, substance use disorders and/or severe and persistent mental illness preferred
Company
Fallon Health
Founded in 1977, Fallon Health is a community-focused not-for-profit health care services organization based in Worcester, Massachusetts.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Dorothy Vandette
Manager, CEO Office
Todd Bailey
Senior Vice President, Chief Financial Officer
Recent News
2026-01-09
2025-08-07
2025-06-07
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