Care Management Director

23 hours ago


Olympia, Washington, United States Centene Corporation Full time
Job Title: Care Management Director

Join Centene Corporation, a leading healthcare company, as a Care Management Director. In this role, you will oversee the care management team and coordinate behavioral health services for our members. Your goal will be to develop and assess high-quality, cost-effective healthcare outcomes related to mental and behavioral health needs.

Key Responsibilities:
  • Manage the care management team and coordinate behavioral health services for our members.
  • Develop and assess high-quality, cost-effective healthcare outcomes related to mental and behavioral health needs.
  • Oversee and review care management required documentation to maintain compliance with federal and state regulations and contractual agreements.
  • Develop, implement, and oversee care management policies and procedures within the care management team based on regulatory requirements and industry standards.
  • Direct the daily activities of care management staff, including reviewing and approving caseloads based on state requirements, care management staff experience, and member needs.
  • Manage escalated and complex care cases, and provide guidance to team members to address member concerns related to mental and behavioral health members.
  • Manage resolutions of complaints and assist in audits and evaluations related to care programs.
  • Develop, implement, and oversee care management programs to facilitate the use of appropriate services and resources.
  • Set goals and objectives for the care management team to achieve cost-effective healthcare results.
  • Work with care management senior management to provide updates and insights on care management team goals.
  • Provide feedback to the care management team to improve member and provider experience and high-quality care.
  • Educate and provide resources for the care management team on key initiatives and member outreach to facilitate ongoing communication between the care management team, members, and providers.
  • Assist care management senior leadership with onboarding, hiring, and training new care management employees, recent promotes, and transfers within the department.
Requirements:
  • Master's degree or graduate from an accredited school of nursing.
  • 5+ years of related experience.
  • Licensed Clinical Behavioral Health Professional or RN based on state contract requirements.
  • Or associated license working towards full licensure required.
Benefits:

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.



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