[Hiring] Behavioral Health Care Manager @Centene Corporation

Role Description

Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substance use disorder.

• This fully remote role involves completing case management related tasks for members receiving complex behavioral health services in the state of Kentucky. The schedule is Monday through Friday, 8-5 PM eastern.
• Evaluates the needs of the member via phone or in-home visits related to the resources available, and recommends and/or facilitates the care plan/service plan for the best outcome, which may include behavioral health and social determinant needs.
• May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources.
• Develops ongoing care plans for members with high level acuity and works to identify providers, specialists, and community resources needed for care including mental health and substance use disorders.
• Coordinates as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members.
• Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs.
• Facilitates care coordination and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services.
• Collects, documents, and maintains member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
• Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs.
• Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner.
• Performs other duties as assigned.
• Complies with all policies and standards.

Qualifications

• Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2 – 4 years of related experience.

Requirements

• Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience required.

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field or office work schedules