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Centene

Runs government-backed health insurance plans

LTSS Service Care Manager - Behavioral Health

Case Management & AdvocacyPosted on Nov 10
Full-timeKansas, USA$27.02 - $48.55 /hr

About the Job

Requirements

  • A Master's degree in Mental Health or Social Work, or graduation from an accredited School of Nursing.
  • Two to four years of related experience.
  • A Licensed Behavioral Health Professional credential or Registered Nurse license, based on state contract requirements; examples include LMSW, LCSW, LMFT, LMHC, LPC, and RN with behavioral health experience.

Responsibilities

  • Develop, assess, and coordinate holistic care management activities, primarily supporting populations with significant mental and behavioral health needs, to enable quality, cost-effective healthcare outcomes.
  • Evaluate member service needs and develop or contribute to the development of care plans or service plans, and educate members, their families, and caregivers on available services and benefits.
  • Evaluate the needs of the most complex and high-risk members with mental and behavioral health needs and recommend a plan of care for the best outcome.
  • Act as a liaison and member advocate between members or families, physicians, and facilities or agencies.
  • Support members with primarily mental and behavioral health needs, including those with or with a history of major depression, bipolar disorders, schizophrenia, borderline personality disorder, post-traumatic stress disorder, substance use disorder, self-injurious behavior, or psychiatric inpatient admissions.
  • Perform frequent home or other site visits, once a month or more, to assess member needs and collaborate with resources as required.
  • Provide or facilitate education for long-term care members and their families or caregivers on preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, and healthcare benefits.
  • Provide subject matter expertise and operational support for mental and behavioral health activities, including crisis calls, mental health first aid training, field safety and de-escalation practices, and psychotropic and other medication monitoring.
  • Educate members about and coordinate community resources, including medical, behavioral, and social services.
  • Coordinate service authorization for members and care managers for services based on service assessments and plans, including meals, employment, housing, foster care, transportation, and activities of daily living.
  • Ensure referrals are appropriate to individual member needs and support identification of providers, specialists, and community resources; ensure identified services are accessible to members.
  • Maintain accurate documentation and support the integrity of care management activities in the electronic care management system.
  • Help ensure compliance with clinical guidelines and current state and federal guidelines.
  • Provide leadership feedback on opportunities to improve quality of care and service delivery for long-term care members in a cost-effective manner.
  • Perform other duties as assigned.
  • Comply with all policies and standards.

Desired Qualifications

  • Candidates residing in northeast Kansas are preferred, particularly those in Johnson, Wyandotte, or Leavenworth counties.

About the Company

Centene

Runs government-backed health insurance plans

Centene runs government-backed health insurance plans in the United States, with Medicaid as its largest business alongside Medicare and Affordable Care Act Marketplace coverage. It is one of the largest Medicaid insurers in the country and also runs plans for people eligible for both Medicare and Medicaid, long-term care and children in foster care. States and the federal government pay Centene a set amount per member to manage care, and individuals buy its Ambetter Marketplace plans, often with federal subsidies. Centene contracts with local doctors, hospitals and pharmacies and keeps the difference between premiums and the cost of care. The company was founded in 1984 in Milwaukee and is headquartered in Clayton, Missouri.

Company size
10,001+
Company stage
IPO
Headquarters
Clayton, MO
Founded
1984

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