Objective: Despite the prevalence of clinical case management services in university counseling centers, there is scant research on practices and effectiveness in case management services. The purpose of this brief report is to review the role of a clinical case manager, examine referral outcomes of referred students, and provide recommendations on case management practices. We hypothesized that students who received referrals at an in-person appointment would be more likely to be successfully referred than those who obtained email referrals. Participants: Two hundred and thirty-four students who obtained referrals from the clinical case manager in the Fall 2019 semester. Methods: A retrospective data analysis was conducted to examine success rates of referrals. Results: In the Fall 2019 semester, 50.4% of students were successfully referred. While 55.6% of in-person appointments were successfully referred compared to 39.2% of email referrals, a chi-square analysis revealed no significant association between type of referral and success of referral, [chi-squared] (4, N = 234) = 8.36, p = 0.08. Conclusions: There was no significant difference in referral outcomes based on type of referral. Recommendations on effective case management practices for university counseling centers are provided.