Care Manager

Centene Corporation

1d•Remote

About The Position

This Care Manager position at Centene involves developing, assessing, and facilitating complex care management activities primarily for members with mental and behavioral health needs. The goal is 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. The role requires evaluating member needs through phone or in-home visits, recommending and facilitating care plans, and coordinating with various resources. This specific position is remote, but the candidate must reside in Missouri and will work with the adolescent foster care population. Centene aims to transform community health and offers a flexible workplace.

Requirements

Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing
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
CANDIDATE MUST RESIDE IN STATE OF MISSOURI

Responsibilities

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.
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.