Supervises the care management team and the care coordination of behavioral health members to promote quality and efficacy of care management delivery related to mental and behavioral health needs. Supervises day-to-day escalations and care management issues related to members or providers. Monitors and reviews care management required documentation to maintain compliance with federal and state regulations and contractual agreements. Assigns caseloads to care management staff based on state requ... more details
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.
Must reside in the state of Delaware. Home and site visits required.
Position Purpose: Supervises the care management team and the care coordination of behavioral health members to promote quality and efficacy of care management delivery related to mental and behavioral health needs. Supervises day-to-day escalations and care management issues related to members or providers.
- Monitors and reviews care management required documentation to maintain compliance with federal and state regulations and contractual agreements
- Assigns caseloads to care management staff based on state requirements, care management staff experience, and member needs
- Works with senior management on escalated and complex care cases related to BH and provides guidance to junior team members to address member concerns
- Educates and provides resources for care management team on key initiatives and member outreach
- Evaluates care management team performance and provides feedback regarding performance, goals, and career milestones
- Provides coaching and guidance to care management team and providers to ensure members are receiving high quality care and information regarding service / care plan options, procedures, referrals, and healthcare benefits
- Monitors and review reports on a regular basis ensuring quality and productivity metrics are met and for case assignments, and may perform audits of staff on a regular basis
- Assists with onboarding, hiring, and training care management team members
- Performs other duties as assigned
- Complies with all policies and standards
Education/Experience: Requires a Master's degree or Graduate from an Accredited School or Nursing and 4+ years of related experience.
License/Certification:
- Licensed Clinical Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, and RN with BH experience required
Pay Range: $83,600.00 - $155,000.00 per year
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. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
