Care Manager

Centene Corporation•Remote-WA State, WA

22d•$56,200 - $101,000•Remote

About The Position

Develops, assesses, and facilitates complex care management activities for members with primarily mental and behavioral health needs to support high-quality, cost-effective healthcare outcomes. The role includes developing personalized care plans and educating members and their families about mental health and substance use disorders. This is a remote position with hours of Monday through Friday, 8:00 a.m. to 5:00 p.m. PST. Candidates must hold active Washington state licensure and/or Compact RN licensure. Pediatric experience is strongly preferred. The Care Manager evaluates member needs by phone or in-home visits, identifies available resources, and recommends or facilitates care plans. The role coordinates with members, families, caregivers, providers, specialists, and community resources; monitors member status and outcomes; documents care management activities; and provides education and feedback to improve care quality and cost-effectiveness. Other duties may be assigned, and the employee must comply with all policies and standards.

Requirements

Master's degree in Behavioral Health or Social Work, or a degree from an accredited school of nursing.
Two to four years of related experience.
Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN, based on state contract requirements; behavioral health experience is required.
Active Washington state licensure and/or Compact RN licensure.

Nice To Haves

Pediatric experience is strongly preferred.

Responsibilities

Evaluates member needs through phone or in-home visits, considers available resources, and recommends or facilitates care plans and services, including for behavioral health and social determinant needs.
Conducts telephonic, digital, home, or other site outreach to assess member needs and collaborate with resources.
Develops ongoing care plans for members with high acuity and identifies providers, specialists, and community resources, including resources for mental health and substance use disorders.
Coordinates among members, families or caregivers, community resources, and care provider teams to help ensure identified services are accessible.
Monitors care plans, member status, and outcomes for changes in treatment side effects, complications, and clinical symptoms, and recommends care plan adjustments based on member needs.
Facilitates care coordination and collaborates with providers or specialists to support 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.
Educates members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, including behavioral health and social determinant needs.
Provides leadership with feedback on opportunities to improve and enhance care and quality delivery cost-effectively.
Performs other duties as assigned.
Complies with all policies and standards.