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Care Manager
2 months ago
At Sunflower Health Plan, we're 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.
Job Summary:We're seeking a skilled LTSS Service Care Manager to join our team. In this role, you'll develop, assess, and coordinate holistic care management activities, with a primary focus on populations with significant mental/behavioral health needs. Your goal will be to enable quality, cost-effective healthcare outcomes.
Key Responsibilities:- Evaluate member service needs and develop or contribute to the development of care plans/service plans.
- Educate members, their families, and caregivers on services and benefits available to meet member needs.
- Act as a liaison and member advocate between the member/family, physician, and facilities/agencies.
- Support members with primarily mental/behavioral health needs, such as those with (or a history of) major depression, bipolar disorders, schizophrenia, borderline personality disorder, post-traumatic stress disorder, substance use disorder, self-injurious behavior, psychiatric inpatient admissions, etc.
- Perform frequent home and/or other site visits (once a month or more) to assess member needs and collaborate with resources, as required.
- Provide and/or facilitate education to long-term care members and their families/caregivers on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, and healthcare benefits.
- Provide subject matter expertise and operational support for relevant mental and behavioral health-focused activities, such as the handling of crisis calls, mental health first aid training, field safety and de-escalation practices, psychotropic and other medication monitoring, etc.
- Educate on and coordinate community resources, to include medical, behavioral, and social services.
- Coordinate service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living).
- Ensure identified services are accessible to members.
- Maintain accurate documentation and support the integrity of care management activities in the electronic care management system.
- Work to ensure compliance with clinical guidelines as well as current state and federal guidelines.
- Provide feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner.
- Master's degree in Mental Health or Social Work or Graduate from an Accredited School of Nursing and 2 – 4 years of related experience.
- Licensed Behavioral Health Professional or RN based on state contract requirements (e.g., LCSW, LMFT, LMHC, LPC, and RN with BH experience).
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.
