Bilingual Care Manager (Spanish)

At Lucet, we are industry leaders in behavioral health, dedicated to helping people live healthy, balanced lives. Our purpose is to advocate for and improve the overall well-being of those we serve, through balanced treatment of the mind and body. When you join Lucet, you become a valued member of our team, serving more than 15 million people across the U.S. Our employees have a passion for helping others - and it shows. From entry-level employees to senior leaders, we are inspired by our members, putting them first in everything we do. From day one, you'll see firsthand the impact you have on our members, knowing you can make a true difference in their lives.

The Bilingual Care Manager Clinician coordinates and oversees comprehensive behavioral health services, ensuring health plan members receive the appropriate level of care while optimizing resource utilization. This role blends care management strategies, such as assessing and developing personalized care plans, engaging members to foster self-management, and supporting recovery, with utilization management practices that include reviewing and authorizing behavioral health services based on medical necessity, treatment guidelines, and outcomes. This role is the single point of contact for a member through the continuum of care, increasing member engagement and continuity. By collaborating with healthcare providers, members, and community resources, this individual ensures that behavioral health services are delivered efficiently, effectively, and in accordance with established policies and procedures. The ability to work in a cross-functional manner, coordinating with all departments within Lucet, health plans, facilities and providers to promote strong health outcomes and stability for our members.

Clinical Expertise & Assessment: Apply expertise in medical necessity, diagnosis, medication management, and psychosocial factors. Conduct assessments to determine treatment needs, barriers, and ensure service compliance with state/federal regulations. Case Management & Care Coordination: Utilize case management processes, including assessments, care planning, and outcome adjustments to optimize member health. Collaborate with members and providers for crisis prevention, care coordination, and aftercare connections. Member & Provider Engagement: Build collaborative relationships with members and providers using motivational interviewing and communication strategies. Educate on mental health, substance abuse resources, and services, and facilitate post-hospital discharge planning. Compliance, Documentation & Professional Development: Stay updated on case management technology, maintain accurate documentation, and adhere to regulatory standards. Engage in audits, quality initiatives, and continuing education for licensure and certification.