Care Manager

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.

Required Licensure: LCSW, LMFT, LPC or RN based with Behavioral Health/ Psychiatric experience is required

Candidates must physically reside in Texas for in-person meetings, if needed

Monday - Friday: 8:00 am - 5:00 pm (CST); NO weekend or holidays

Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substance use disorder.

• Evaluates the needs of the member via phone or in-home visits related to the resources available, and recommends and/or facilitates the care plan/service plan for the best outcome, which may include behavioral health and social determinant needs
• May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources
• Develops ongoing care plans for members with high level acuity and works to identify providers, specialists, and community resources needed for care including mental health and substance use disorders
• Coordinates as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members
• Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs
• Facilitates care coordination and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services
• Collects, documents, and maintains 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
• Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience: Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2 – 4 years of related experience.

License/Certification:

• Licensed Behavioral Health Professional - LCSW, LPC, LMFT, or RN with BH experience is required based on state contract requirements

Preferred Experience:

• Clinical Behavioral Health and/or Case Management experience in Mental Health Authorities (MHAs), Local Intellectual Developmental Disabilities Authorities (LIDDA), Inpatient or Outpatient Psychiatric or Behavioral Health hospitals, Substance Abuse Recovery Treatment centers, community-based Counseling/ Mental Health environments, or Behavioral Health Managed Care organizations
• Experience conducting intake assessments and care coordination of formal healthcare and behavioral services
• Experience working with adults (18 – 65), legal guardians, or legal representatives of minors is a major plus.
• Role requires strong adaptability, flexibility, and resiliency skills.
• Must have proficient computer skills with Microsoft and Video Conferencing applications (e.g. Outlook, Word, Excel, ZOOM, MS Teams)
• Must be able to work independently with minimal supervision.
• Bilingual – Spanish and English is a plus but not required.

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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act