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Centene

Runs government-backed health insurance plans

LTSS Service Care Manager - Behavioral Health

Mental & Behavioral HealthConfirmed live in the last 24 hours
Full-time$27.02 - $48.55 /hr

About the Job

Requirements

  • Requires a master's degree in Mental Health or Social Work, or graduation from an accredited school of nursing.
  • Requires 2–4 years of related experience.
  • Requires a licensed behavioral health professional or registered nurse based on state contract requirements: LCSW, LMFT, LMHC, LPC, or RN with direct behavioral health experience.
  • Requires strong clinical documentation and problem-solving skills.
  • Requires openness, adaptability, and flexibility for business changes.
  • Requires strong communication, organizational, and time-management skills.
  • Requires proficiency with Microsoft Office applications, including MS 365 Copilot, Excel, Outlook, OneNote, Word, PowerPoint, and Teams.
  • Requires a working knowledge of Medicaid, STAR Plus, Medicaid Waiver, or state and government-sponsored program guidelines.

Responsibilities

  • Develop, assess, and coordinate holistic care management activities focused on populations with significant mental and behavioral health needs to support 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 services and benefits that address member needs.
  • Evaluate the needs of complex, high-risk members with mental and behavioral health needs and recommend a plan of care.
  • Act as liaison and member advocate between members and their families, physicians, and facilities or agencies.
  • Support members with mental and behavioral health needs, including those 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.
  • Conduct frequent home or other site visits, once a month or more, to assess member needs and coordinate 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-call handling, 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 assessments and plans, such as meals, employment, housing, 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 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 cost-effectively.
  • Perform other duties as assigned.
  • Comply with all policies and standards.
  • Travel for member visits in Navarro County and surrounding areas; mileage is reimbursed.

Desired Qualifications

  • Three or more years of post-graduate direct clinical behavioral health experience in case management, care coordination, treatment planning, psychological assessments, crisis intervention, or discharge planning.
  • Direct work experience as a community-based or field-based case manager or care coordinator.
  • Three or more years of experience assessing adult members with complex mental health or serious and persistent mental illness conditions in inpatient psychiatric hospitals or units, residential treatment centers, substance abuse rehabilitation facilities, military or veteran hospitals, or local and state mental health authorities.

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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