LPN Collaborative Care Model (CoCM) Behavioral Health Care Manager

Location: Cleveland, OH (In Office) Schedule: Full-Time Salary: $64,000 - $70,000 per year

Position Summary

Infinite Medical P.C. is seeking a dedicated Licensed Practical Nurse (LPN) to serve as a Behavioral Health Care Manager within our Collaborative Care Model (CoCM) program.

This is an in-office, non-face-to-face care management position. The LPN Behavioral Health Care Manager remotely supports residents in skilled nursing and long-term care facilities through medical record review, behavioral health screening, care planning, registry management, care-team collaboration, and psychiatric case consultation.

The Behavioral Health Care Manager works as part of an integrated care team that includes the treating medical provider, psychiatric consultant, clinical leadership, facility staff, and other members of the patient's care team. This position does not independently diagnose conditions, prescribe medications, or replace the treating provider.

Essential Responsibilities

Patient Assessment and Monitoring

• Review patient medical records, diagnoses, medications, behavioral health documentation, provider notes, laboratory results, and relevant changes in condition.
• Document validated behavioral health screening and monitoring tools, as appropriate, including PHQ-9, GAD-7, MoCA, BIMS, and other approved assessments.
• Monitor patients' behavioral health symptoms, treatment response, functional status, medication changes, and progress toward established goals.
• Identify changes in patient status, potential safety concerns, documentation inconsistencies, medication-related concerns, and other findings requiring escalation.
• Maintain ongoing, non-face-to-face contact with patients, authorized representatives, facility staff, and members of the care team when clinically appropriate and permitted.

Care Planning and Coordination

• Develop and maintain individualized behavioral health care plans in collaboration with the treating provider and interdisciplinary care team.
• Update care plans when a patient's condition, treatment, medications, screening results, or goals change.
• Assist with coordinating behavioral health services and follow-up recommendations.
• Support brief, evidence-based behavioral health interventions within the employee's training, licensure, organizational policy, and established clinical protocols.
• Communicate relevant clinical findings and care gaps to providers, facility staff, and clinical leadership.
• Facilitate collaboration among the patient's medical, behavioral health, and facility-based care teams.

Psychiatric Consultation

• Prepare organized patient case summaries for review with the psychiatric consultant.
• Participate in scheduled psychiatric case-review meetings, generally lasting approximately 30 minutes.
• Present relevant clinical information, including diagnoses, behavioral symptoms, screening scores, medications, recent changes, treatment response, safety concerns, and barriers to improvement.
• Document psychiatric recommendations accurately and communicate them to the treating provider for review and clinical decision-making.
• Track the implementation and outcome of recommendations and identify patients who may require additional psychiatric review.
• Escalate urgent behavioral health or safety concerns according to established clinical protocols.

Registry and Documentation Management

• Maintain accurate and current patient information in the CoCM registry and other approved tracking systems.
• Track patient enrollment, outreach, screening results, care-plan updates, psychiatric reviews, provider recommendations, follow-up needs, and patient progress.
• Complete timely, accurate, and compliant documentation of all care-management activities.
• Record time spent performing qualifying CoCM activities in accordance with organizational and billing requirements.
• Ensure documentation supports continuity of care, clinical oversight, quality review, and applicable billing standards.
• Complete assigned patient charts and required psychiatric consultations within established deadlines.

Quality and Compliance

• Follow all CoCM policies, clinical workflows, documentation standards, HIPAA requirements, and organizational procedures.
• Participate in chart audits, education, coaching, competency reviews, and performance-improvement initiatives.
• Correct documentation or workflow deficiencies within required timeframes.
• Maintain professional and timely communication with providers, clinical leadership, psychiatric consultants, facility staff, and other care-team members.
• Meet established expectations for productivity, documentation quality, responsiveness, and patient follow-up.

Required Qualifications

• Active and unrestricted Licensed Practical Nurse (LPN) license.
• Graduate of an accredited practical nursing program.
• Strong clinical documentation and medical-record review skills.
• Ability to recognize and appropriately escalate behavioral health, medication, and patient-safety concerns.
• Strong written, verbal, organizational, and time-management skills.
• Ability to manage multiple patients, deadlines, and follow-up responsibilities in a structured, high-volume environment.
• Ability to collaborate effectively with providers, psychiatric consultants, facility staff, and clinical leadership.
• Proficiency with electronic medical records and computer-based tracking systems.
• Ability to maintain patient confidentiality and comply with HIPAA and organizational privacy requirements.

Preferred Qualifications

• Experience in skilled nursing, long-term care, or geriatric care.
• Experience in behavioral health, psychiatric nursing, or care management.
• Familiarity with the Collaborative Care Model, Behavioral Health Integration, or other value-based care programs.
• Experience participating in interdisciplinary or psychiatric case-review meetings.