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Centene

Runs government-backed health insurance plans

LPC – LCSW - Behavioral Health RN Care Manager

Mental & Behavioral HealthPosted on Nov 10
Full-time$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, is required.
  • Two to four years of related behavioral health or mental health experience is required.
  • A Licensed Behavioral Health Professional credential or Registered Nurse qualification with behavioral health experience is required based on state contract requirements; examples include LPC, LCSW, LMFT, or RN with behavioral health experience.
  • Candidates must accommodate child and adolescent members' school schedules when needed.
  • Strong clinical documentation, problem-solving, communication, attention to detail, organizational, and time-management skills are required.
  • Proficient technology skills and direct experience using Microsoft Office applications and video-conferencing applications are required.
  • Ability to work independently with minimal supervision is required.

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 care plans and service plans; educate members, families, and caregivers about available services and benefits.
  • Evaluate the needs of the most complex and high-risk members with mental and behavioral health needs and recommend plans of care.
  • Act as a liaison and member advocate among members and families, physicians, and facilities or agencies.
  • Support members with mental and behavioral health needs, including conditions such as major depression, bipolar disorders, schizophrenia, borderline personality disorder, post-traumatic stress disorder, substance use disorder, self-injurious behavior, and psychiatric inpatient admissions.
  • Conduct 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 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 medical, behavioral, and social services.
  • Coordinate service authorizations based on service assessments and plans, including services such as meals, employment, housing, foster care, transportation, and activities of daily living.
  • Make appropriate referrals based on member needs and support identification of providers, specialists, and community resources; ensure identified services are accessible to members.
  • Maintain accurate documentation in the electronic care-management system and support the integrity of care-management activities.
  • Help ensure compliance with clinical guidelines and current state and federal guidelines.
  • Provide leadership with feedback on opportunities to improve quality of care and service delivery for long-term care members cost-effectively.
  • Perform other duties as assigned.
  • Comply with all policies and standards.

Desired Qualifications

  • Five or more years of behavioral health case-management experience with child and adolescent members, preferably in inpatient psychiatric hospitals, community-based counseling programs, school or college/university settings, residential treatment centers, or local or state LIDDAs or MHAs.
  • Direct experience as a field-based case manager or social worker is strongly preferred.
  • Experience collaborating with medical and behavioral health providers and managing community resources for Medicaid recipients.
  • Experience managing high-volume caseloads.
  • Ability to adapt to changing business needs with openness, flexibility, and professionalism.
  • Experience with government and state-sponsored programs such as STAR Kids, CHIP, Medicaid, or MDCP.
  • Bilingual English and Spanish skills are a plus but are not required.

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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