Behavioral Health Service Mgr

Centene Corporation•Remote-FL, FL

2d•$27 - $49•Remote

About The Position

Perform duties related to the day-to-day operations of the Service Management functions for Foster Care members to achieve the highest possible levels of functioning and wellness by ensuring consistent, timely access to medically necessary behavioral health services. Monitor quality of care, assist with discharge planning. Centene is seeking a remote Behavioral Health Service Manager to support our Medicaid business across 12 markets. The ideal candidate will bring a strong behavioral health and clinical background, including experience with case management or utilization management, high-volume clinical reviews, medication monitoring, and medication management. This fast-paced role requires excellent organization, sound clinical judgment, and the ability to manage competing priorities while ensuring timely and accurate caseload management decisions.

Requirements

Master's degree in Behavioral Health.
3+ years of case and/or utilization management experience.
Experience in psychiatric health care settings, child behavioral health conditions and members with special needs.
Working knowledge of utilization review procedures, and familiarity with mental health community resources.
Thorough knowledge of a specialized or technical field such as clinical nursing, case and/or utilization management involving knowledge plus the application of basic theory.
Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
Unrestricted license as a LCSW, LMFT, LMHC, LPC, PhD, PsyD or RN.

Nice To Haves

Foster care experience strongly preferred.

Responsibilities

Work with Foster Care Members, Medical Consenters, Department of Family and Protective Services (DFPS) staff and providers to meet the behavioral healthcare needs of each foster care member’s condition.
Identify foster care members who may benefit from service management, conduct an assessment and develop, implement and monitor a healthcare service plan.
Provide information to DFPS staff to facilitate development of the DFPS case plan.
Update database regularly with most recent Service Management Plan of Care.
Review information submitted by providers into the database to ensure material is appropriate and consistent with guidelines for data inclusion.
Encourage behavioral health providers to use evidence-based practices and confirm that behavioral health providers and PCP’s are sharing information as required.
Comply with established referral, pre-certification and authorization policies, procedures and processes by related medical management staff.
Maintain compliance with federal and state regulations and contractual agreements.
Coordinate service management functions with other departmental functions.
Monitor data to address trends or potential quality improvement opportunities.
Maintain HIPAA compliance.
Performs other duties as assigned
Complies with all policies and standards