Lyra Health is the leading provider of mental health solutions for employers supporting more than 20 million people globally. The company has delivered 13 million sessions of mental health care published more than 20 peer-reviewed studies and delivered unmatched outcomes in terms of access clinical effectiveness and cost efficiency. Extensive peer-reviewed research confirms Lyras transformative care model helps people recover twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental health care through Lyra Empower the only fully integrated AI-powered platform combining the highest-quality care and technology solutions.
We are seeking a highly experienced and expert Senior Clinical Case Manager to join our dynamic clinical this pivotal individual contributor role you will be responsible for managing complex cases providing expert clinical review and acting as a subject matter expert for evidence-based care within our international partner provider network. Your deep clinical knowledge and exceptional case management skills will ensure that Lyra Global service users receive the highest quality professional and effective mental health care.
This is a full time role based Monday to Friday working remotely in South Africa.
Core Responsibilities
Expert Clinical Case Management:
Manage a complex caseload from initiation through resolution including continuous monitoring and follow-up of relevant documentation from all parties (affiliate client etc.).
Provide expert clinical consultation and supervision to providers on detailed treatment plans and the delivery of evidence-based care for challenging cases.
Ensure all treatment plans adhere to a goal-oriented intervention with a strong workplace focus (when appropriate) aimed at significantly improving the employees level of functioning within the workplace (work impact).
Rigorously monitor and manage data quality across all clinical metrics (including clinical problems & sessions work impact CORE-10 satisfaction) ensuring accuracy and integrity.
Ensure overall high levels of satisfaction with services delivered by proactively addressing any clinical concerns.
Ensure affiliate counsellors consistently adhere to all clinical protocols including risk management standards procedures and service level agreements with a focus on complex cases.
Referral & Resource Facilitation:
Expertly signpost clients into appropriate external resources and liaise effectively with external stakeholders to facilitate specialized referrals where appropriate (e.g. hospitalisation rehabilitation).
Facilitate complex referrals into the preferred partner network when needed to support critical capacity gaps highly specialized clinical needs or cross-border challenges.
Clinical Training & Standards Adherence:
Contribute to the development and refinement of advanced training materials for affiliates on complex clinical protocols intricate risk management scenarios cross-border referrals and challenging case management strategies.
Provide advanced clinical guidance during the onboarding and training of affiliate counsellors in clinical protocols standards and the sophisticated use of the clinical database for complex cases.
Assist with keeping advanced training materials up to date based on evolving clinical best practices and complex case learnings.
Collaboration & Problem Solving:
Collaborate proactively with provider relations and clinical teams to ensure a seamless and high-quality global experience particularly for complex or sensitive cases.
Support providers with maintaining accurate professional bios up-to-date clinical specialties for specialized referrals and ensuring accurate and effective use of the scheduling tool for complex client needs.
Investigate and work to resolve complex complaints from both clients and providers often requiring advanced clinical judgment and de-escalation skills.
Proactively identify customer-specific or other significant clinical themes and trends from case management activities and communicate this information to operations leadership and client services/customer success for strategic management of client contracts and value-add initiatives.
Qualifications
Education: Minimum of a Masters Qualification as a Psychologist / Social Worker
Registration: Active and unrestricted registration/licensure with a relevant clinical body (e.g. HPCSA / SACSSP or equivalent international clinical regulatory body) in good standing.
Experience
Minimum of 8 years of progressive working experience in a clinical setting with significant exposure to complex case management.
Strong preference for candidates with a background and extensive working experience in the Employee Assistance Program (EAP) or workplace mental health field particularly with complex return-to-work or work-impact cases.
Experience working internationally and navigating diverse healthcare systems and cultural nuances is highly preferred.
Proficiency in Google Suite and CRM systems is preferred.
Minimum skillset required
Excellent customer service skills
Excellent clinical skills and judgement
Experience with managing high risk cases
Excellent English speaking and writing abilities
Adept at cross cultural communication and collaboration
Other key details
Clinical Acumen: Exceptional clinical understanding and the advanced ability to identify assess and manage high-level clinical risk and complex psychological presentations.
Problem Solver: Highly analytical with superior problem-solving skills capable of navigating intricate clinical and operational challenges independently.
Autonomous & Accountable: Able to work independently without close supervision while ensuring all key issues are escalated appropriately and critical decisions are clinically sound.
Detail-Oriented: Meticulous attention to detail ensuring accuracy of data maintaining strict confidentiality and adhering to complex clinical procedures.
Communicator: Excellent verbal and written communication skills with the ability to articulate complex clinical concepts clearly and professionally to diverse stakeholders internationally.
Proactive & Adaptive: Strong continuous improvement mindset always seeking opportunities to innovate and refine clinical processes. Flexible adaptable and thrives in a fast-paced evolving international environment.
Organized: Highly organized with exceptional ability to plan prioritize and manage a high-volume complex caseload effectively to meet deadlines and perform under pressure.
Collaborative: A strong team player who readily accepts change and collaborates effectively with internal and external partners while maintaining a focus on individual case responsibilities
We are an Equal Opportunity Employer. We do not discriminate on the basis of race color religion sex (including pregnancy) national origin age disabilitygenetic information or any other category protected by law.
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