Manager, Care Management

Centene Corporation•Remote-OH, OH

1d•$102,900 - $190,500•Remote

About The Position

Centene is hiring a remote Manager, Care Management, to support our Buckeye Medicaid plan and oversee a team of clinicians. The selected candidate must reside in Ohio and hold an active clinical license in the state. The ideal candidate will bring leadership experience along with a strong background in behavioral health, managed care, case management or community mental health centers, and utilization review, as well as excellent communication and presentation skills.

Requirements

Master's degree or Graduate from an Accredited School of Nursing
5+ years of related experience
Licensed Clinical Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, and RN with BH experience required
Reside in Ohio
Hold an active clinical license in the state of Ohio
Leadership experience
Strong background in behavioral health, managed care, case management or community mental health centers, and utilization review
Excellent communication and presentation skills

Responsibilities

Oversees and reviews care management required documentation to maintain compliance with federal and state regulations and contractual agreements
Develops, implements, and oversees care management policies and procedures within the care management team based on regulatory requirements and industry standards
Directs the daily activities of care management staff including reviewing and approving the caseloads of care management staff based on state requirements, care management staff experience, and member needs
Manages escalated and complex care cases, and provides guidance to team members to address member concerns related to mental and behavioral health members
Manages resolutions of complaints and assists in audits and evaluations related to care programs
Develops, implements, and oversees care management programs to facilitate the use of appropriate services and resources
Sets goals and objectives for care management team to achieve cost-effective healthcare results
Works with care management senior management to provide updates and insights on care management team goals
Provides feedback to care management team to improve member and provider experience and high-quality care
Educates and provides resources for care management team on key initiatives and member outreach to facilitate on-going communication between care management team, members, and providers
Assists care management senior leadership with onboarding, hiring, and training new care management employees, recent promotes, and transfers within the department
Performs other duties as assigned
Complies with all policies and standards