LTSS Service Care Manager - Behavioral Health, STAR Kids

Centene Corporation•Manchaca, TX

13d•$27 - $49•Hybrid

About The Position

Develops, assesses and coordinates holistic care management activities, with primary focus and support towards populations with significant mental/behavioral health needs, to enable quality, cost-effective healthcare outcomes. Evaluates member service needs and develops or contributes to development of care plans/service plans, and educates members, their families and caregivers on services and benefits available to meet member needs.

Requirements

An unrestricted behavioral health professional license based on state contract requirements (e.g., LCSW, LMFT, LMHC, LPC, or RN with direct Behavioral Health experience) is required for the applicable state upon application submission.
Requires a Master's degree in Mental Health or Social Work or Graduate from an Accredited School of Nursing and 2 – 4 years of related behavioral health/mental health experience.
Strong clinical documentation, problem-solving, communication, attention to detail, organizational, and time management skills required.
Ability to adapt to changing business needs with openness, flexibility, and professionalism.
Proficient technology skills and direct experience working within web-based applications and case management systems (i.e. TruCare, Microsoft Office Site – Outlook, M365 Copilot, Excel, PowerPoint, Word, OneNote, etc).
Must be able to work independently with minimal supervision.
Licensed Behavioral Health Professional or RN based on state contract requirements (e.g., LPC, LCSW, LMFT, LMHC, RN with BH experience) is required

Nice To Haves

5+ years of Behavioral Health Case Management experience, preferably within inpatient psychiatric hospitals, community-based counseling programs, school or college/university settings, residential treatment centers, or local or state LIDDAs, MHA/BHAs for youth
Direct experience as a Field-based Case Manager or Social Worker is strongly preferred
Experience collaborating with medical and behavioral health providers and managing community resources for Medicaid recipients.
Experience managing high volume caseloads
Experience working in managed care environment is a PLUS (Federal and State Sponsored Govt Programs)
Bilingual English/Spanish skills are a plus but not required.

Responsibilities

Evaluates the needs of the most complex and high-risk members with mental/behavioral health needs, and recommends a plan of care for the best outcome
Acts as liaison and member advocate between the member/family, physician, and facilities/agencies
Supports members with primarily mental/behavioral health needs, such as those with (or a history of) major depression, bipolar disorders, schizophrenia, borderline personality disorder, post-traumatic stress disorder, substance use disorder, self-injurious behavior, psychiatric inpatient admissions, etc
Performs frequent home and/or other site visits (up to 75% monthly travel for home visits) to assess member needs and collaborate resources, as required
Provides and/or facilitates education to long-term care members and their families/caregivers on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, and healthcare benefits.
Provides subject matter expertise and operational support for relevant mental and behavioral health-focused activities, such as the handling of crisis calls, mental health first aid training, field safety and de-escalation practices, psychotropic and other medication monitoring, etc
Educates on and coordinates community resources, to include medical, behavioral and social services.
Provides coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living)
Ensures appropriate referrals based on individual member needs and supports the identification of providers, specialists, and community resources.
Ensures identified services are accessible to members
Maintains accurate documentation and supports the integrity of care management activities in the electronic care management system.
Works to ensure compliance with clinical guidelines as well as current state and federal guidelines
Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
Performs other duties as assigned
Comply with all policies and standards
Travel to conduct member visits is required