Care Manager (Behavioral Health)

Centene Corporation•Remote-NJ, NJ

2d•$56,200 - $101,000•Remote

About The Position

Centene is transforming the health of its communities, one person at a time. This role develops, assesses, and facilitates complex care management activities for members with primarily mental and behavioral health needs to achieve high-quality, cost-effective healthcare outcomes. The position involves creating personalized care plans and providing education to members and their families regarding mental health and substance use disorders. The role requires serving members in Passaic and Sussex Counties, New Jersey, with up to 50% local travel. Candidates must reside in Passaic or Sussex Counties, or a nearby bordering county. The closest company office is in Iselin, NJ.

Requirements

Active New Jersey license required
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.
Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience required
For NJ Health Plan Only: Requires a Master's degree in Behavioral Health or Social Work and a Licensed Associate Counselor (LAC) or Licensed Social Worker (LSW) required

Responsibilities

Evaluates member needs via phone or in-home visits related to available resources, and recommends/facilitates care plans for optimal outcomes, including behavioral health and social determinant needs.
Performs 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 acuity, identifying necessary providers, specialists, and community resources, including those for mental health and substance use disorders.
Coordinates between the member/family/caregivers, community resources, and the care provider team to ensure accessibility of identified services.
Monitors care plans/member status and outcomes for changes in treatment side effects, complications, and clinical symptoms, providing recommendations based on identified member needs.
Facilitates care coordination and collaborates with appropriate providers or specialists to ensure timely access to needed care or services.
Collects, documents, and maintains member information and care management activities to ensure compliance with state, federal, and third-party payer regulations.
Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, including 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.