Senior Care Manager

1 week ago

Olympia, Washington, United States Centene Corporation Full time
Job Title: Senior Care Manager

Join Centene Corporation, a leading healthcare company, as a Senior Care Manager. In this role, you will play a critical part in transforming the health of our communities, one person at a time.

Job Summary:

We are seeking a highly skilled Senior Care Manager to develop, assess, and implement complex care management activities based on member needs. As a Senior Care Manager, you will work primarily with behavioral health needs, including mental health and social determinants, to provide quality, cost-effective healthcare outcomes.

Key Responsibilities:
  • Develop and continuously assess ongoing care plans/service plans of members with high-level acuity via phone or in-home visits.
  • Identify providers, specialists, and community resources needed for care, including mental health and social determinant needs.
  • Coordinate and manage between the member and/or family and the care provider team to ensure identified services are accessible to members.
  • Maintain a caseload with a higher volume of complex/specialty cases.
  • Monitor member status and outcomes for changes in treatment side effects, complications, and clinical symptoms and revise care plan/service plan based on member needs and issues identified.
  • Identify problems/barriers for care coordination and appropriate care management interventions for advanced and complex cases, including mental health and substance use disorders.
  • Review member data to identify health risks and/or care gaps and improve operating performance and quality care to address member's needs/issues and provide recommendations in accordance with state and federal regulations.
  • Collaborate with healthcare providers and partners, including behavioral health, as appropriate to facilitate care coordination and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services.
  • Collect, document, and maintain all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
  • Provide 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.
  • Partner 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.
  • Engage and assist new hire/preceptee during onboarding journey, including responsibility for completing competency check points ensuring readiness for Service Coordination success.
  • Engage in a collaborative and ongoing process with People Leaders and cross-functional teams to measure and monitor readiness.
  • Perform other duties as assigned.
  • Comply with all policies and standards.
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 require.
  • Washington licensure required.
What We Offer:

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. Total compensation may also include additional forms of incentives.

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.

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