Senior Care Manager
About The Position
Centene is seeking a licensed clinician to support the MHS Health Wisconsin plan. The Senior Care Manager develops, assesses, plans, implements, and coordinates complex care management based primarily on members’ behavioral health and social needs, with the goal of achieving quality, cost-effective outcomes. The role develops personalized care or service plans and educates members and their families or caregivers about available services and benefits. This is a hybrid opportunity involving approximately 50% field-based visits throughout the Milwaukee area. The Senior Care Manager builds member relationships and coordinates person-centered care, including identifying providers, specialists, and community resources. The position handles a higher volume of complex and specialty cases and may also support the onboarding and development of clinical new hires.
Requirements
- Master’s degree in Behavioral Health or Social Work, or a degree from an accredited school of nursing.
- 4–6 years of related experience.
- Licensed Master’s Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, or LPC), or RN, as required by state contract requirements.
- Behavioral health experience is required.
- Must be a licensed clinician.
Nice To Haves
- Case management and managed care experience.
- Familiarity with HMO and/or Medicaid plans.
- Knowledge of programs such as SSI and TANF.
Responsibilities
- Develop and continuously assess care or service plans for high-acuity members through phone and in-home visits, identifying providers, specialists, and community resources for mental health and social determinant needs.
- Conduct outreach through telephonic, digital, home, or other site visits to assess member needs and collaborate with resources.
- Coordinate between members or their families and care provider teams to help ensure identified services are accessible.
- Maintain a caseload with a higher volume of complex and specialty cases.
- Monitor member status and outcomes for changes in treatment side effects, complications, and clinical symptoms, and revise care plans based on identified needs, including mental health and substance use disorders.
- Identify care coordination problems and barriers and determine appropriate care management interventions for advanced and complex cases.
- Review member data to identify health risks or care gaps, improve operating performance and quality of care, address member needs, and provide recommendations in accordance with state and federal regulations.
- Review referral information and intake assessments to develop care plans for complex and specialty cases.
- Collaborate with healthcare providers and partners, including behavioral health providers, to facilitate coordination and timely access to needed care and services.
- Collect, document, and maintain member information and care management activities in compliance with state, federal, and third-party payer requirements.
- Educate members and their families about procedures, provider instructions, treatment options, referrals, and healthcare benefits, including behavioral health and social determinant needs.
- Partner with leadership to improve care and quality delivery in a cost-effective manner.
- May precept clinical new hires by coaching them, developing core skills, facilitating growth, and guiding onboarding.
- Provide guidance and support to new hires and preceptees as they navigate a Managed Care Organization, including coaching and shadowing to connect classroom training with field practice.
- Support new hires during onboarding, complete competency checkpoints, and assess readiness for Service Coordination work.
- Work with People Leaders and cross-functional teams to measure and monitor readiness.
- Perform other duties as assigned and comply with all policies and standards.
Benefits
- Competitive pay
- Health insurance
- 401K and stock purchase plans
- Tuition reimbursement
- Paid time off and holidays
- Flexible approach to work schedules, including remote, hybrid, field, or office work
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What This Job Offers
Job Type
Full-time
Career Level
Senior
