Full-Time

Senior Care Manager

Confirmed live in the last 24 hours

Centene

Centene

10,001+ employees

Provides health insurance and services

Healthcare

Compensation Overview

$73.8k - $132.7kAnnually

Senior

Remote in USA

Candidates must be licensed in Washington.

Category
Nursing & Allied Health Professionals
Medical, Clinical & Veterinary

You match the following Centene's candidate preferences

Employers are more likely to interview you if you match these preferences:

Degree
Experience
Requirements
  • Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 4 – 6 years of related experience.
  • Licensed Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, LPC and RN with BH experience required.
  • For Washington plan only: Licensed Behavioral Health Professional or RN (State Licensure and/or Compact State Licensure) based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, LPC and RN with BH experience.
Responsibilities
  • Develops and continuously assesses ongoing care plans/service plans of the members with high level acuity via phone and works to identify providers, specialists, and community resources needed for care including mental health and social determinant needs.
  • Coordinates and manages, as appropriate, between the member and/or family and the care provider team to ensure identified services are accessible to members.
  • Maintains a caseload with higher volume of complex/specialty cases.
  • Monitors member status and outcomes for changes in treatment side effects, complications and clinical symptoms and revises care plan/service plan based on member needs and issues identified including mental health and substance use disorders.
  • Identifies problems/barriers for care coordination and appropriate care management interventions for advanced and complex cases including mental health and substance use disorders.
  • Reviews member data to identify health risks and/or care gaps, and improve operating performance and quality care to address member’s needs/issues and provides recommendations in accordance with state and federal regulations.
  • Reviews referrals information and intake assessments to develop appropriate care plan for complex/specialty cases.
  • Collaborates with healthcare providers and partners (including behavioral) as appropriate to facilitate care coordination and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services.
  • Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
  • Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs.
  • Partners with leadership team to improve and enhance care and quality delivery for members in a cost-effective manner.
  • May precept clinical new hires by fostering and building core skills, coaching and facilitating their growth, and guiding through the onboarding process to upskill readiness.
  • Provides guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities to bridge gap between classroom training and field practice.
  • Engages and assists new hire/preceptee during onboarding journey including responsibility for completing competency check points ensuring readiness for Service Coordination success.
  • Engages in a collaborative and ongoing process with People Leaders and cross functional teams to measure and monitor readiness.
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Centene Corporation operates in the healthcare industry, focusing on providing health insurance and services to individuals, particularly those who are underinsured or uninsured. The company offers a variety of health insurance products, including medical, dental, vision, and behavioral health services, as well as pharmacy benefits. Centene's business model emphasizes a localized approach, allowing it to tailor its services to meet the specific needs of different communities across the United States. This strategy sets Centene apart from competitors by ensuring that care is relevant and accessible to its members. The company generates revenue primarily through premiums collected from its 27.5 million members, amounting to $140.1 billion in 2023. Centene's goal is to improve health outcomes while managing costs, and it is committed to corporate sustainability, addressing social barriers to health, and supporting employee well-being through flexible work arrangements.

Company Stage

IPO

Total Funding

N/A

Headquarters

Saint-Louis, Senegal

Founded

1984

Simplify Jobs

Simplify's Take

What believers are saying

  • Centene's membership increased by 12% in Marketplace and 50% in Medicare PDP in 2024.
  • The expansion of low-cost plans like Fidelis Care's Essential Plan increases healthcare accessibility.
  • Centene's ICHRA plans offer customizable and transparent health insurance options.

What critics are saying

  • Increased competition in the Health Insurance Marketplace may pressure Centene's market share.
  • Reliance on government contracts exposes Centene to political and policy changes.
  • Natural disasters and new health threats could strain Centene's operational capabilities.

What makes Centene unique

  • Centene's localized approach tailors healthcare services to specific community needs.
  • The company offers a wide range of health insurance products through local brands.
  • Centene focuses on cost-effective, high-quality care for underinsured and uninsured individuals.

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Benefits

Health Insurance

401(k) Retirement Plan

401(k) Company Match

Paid Vacation

Hybrid Work Options

Flexible Work Hours