Care Manager

4 weeks ago


Honolulu, Hawaii, United States Centene Corporation Full time
Job Summary:

Centene Corporation is seeking a skilled Care Manager - Behavioral Health Specialist to join our team. As a key member of our care management team, you will be responsible for developing, assessing, and facilitating complex care management activities for primarily mental and behavioral health needs members. Your goal will be 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.

Key Responsibilities:

* Evaluate the needs of members via phone or in-home visits related to the resources available, and recommend and/or facilitate the care plan/service plan for the best outcome, which may include behavioral health and social determinant needs
* Perform telephonic, digital, home, and/or other site visits outreach to assess member needs and collaborate with resources
* Develop ongoing care plans for members with high-level acuity and work to identify providers, specialists, and community resources needed for care, including mental health and substance use disorders
* Coordinate as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members
* Monitor care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications, and clinical symptoms and provide recommendations to care plan/service plan based on identified member needs
* 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 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
* Provide feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner

Requirements:

* Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and - 4 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 required

What We Offer:

Centene Corporation 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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