Care Manager

Centene Corporation

6d • Remote

About The Position

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Active Washington (WA) Clinical License: LCSW, LMSW, LMFT, LMHC, LPC, or RN Standard schedule: Monday–Friday, 8:00 AM–5:00 PM (PT) Time zone requirement: Candidates must be able to work Pacific Time (PT) hours, regardless of their local time zone. Program Supported: Integrated Foster Care Experience managing or supporting behavioral health and care services for foster youth ages 0–26 Ability to manage inbound/outbound calls, coordinate with hospitals, and support care transitions Strong ability to support crisis interventions and navigate complex cases Strong crisis management, engagement, and communication skills Position Purpose: 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.

Requirements

• 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
• Active Washington (WA) Clinical License: LCSW, LMSW, LMFT, LMHC, LPC, or RN
• Candidates must be able to work Pacific Time (PT) hours, regardless of their local time zone.
• Experience managing or supporting behavioral health and care services for foster youth ages 0–26
• Ability to manage inbound/outbound calls, coordinate with hospitals, and support care transitions
• Strong ability to support crisis interventions and navigate complex cases
• Strong crisis management, engagement, and communication skills

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.

Benefits

• Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.
• Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.
• Total compensation may also include additional forms of incentives.
• Benefits may be subject to program eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees