[Hiring] Manager, Care Management @Centene Corporation

Role Description

Manages the care management team and the care coordination of behavioral health members to develop and assess high quality, cost-effective healthcare outcomes related to mental and behavioral health needs. Manages escalations and care management issues related to members or providers.

• Oversees and reviews care management required documentation to maintain compliance with federal and state regulations and contractual agreements.
• Develops, implements, and oversees care management policies and procedures within the care management team based on regulatory requirements and industry standards.
• Directs the daily activities of care management staff including reviewing and approving the caseloads of care management staff based on state requirements, care management staff experience, and member needs.
• Manages escalated and complex care cases, and provides guidance to team members to address member concerns related to mental and behavioral health members.
• Manages resolutions of complaints and assists in audits and evaluations related to care programs.
• Develops, implements, and oversees care management programs to facilitate the use of appropriate services and resources.
• Sets goals and objectives for care management team to achieve cost-effective healthcare results.
• Works with care management senior management to provide updates and insights on care management team goals.
• Provides feedback to care management team to improve member and provider experience and high-quality care.
• Educates and provides resources for care management team on key initiatives and member outreach to facilitate ongoing communication between care management team, members, and providers.
• Assists care management senior leadership with onboarding, hiring, and training new care management employees, recent promotes, and transfers within the department.
• Performs other duties as assigned.
• Complies with all policies and standards.

Qualifications

• Requires a Master's degree or Graduate from an Accredited School of Nursing and 5+ years of related experience.

Requirements

• Licensed Clinical Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, and RN 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.