Care Management Team Lead
3 weeks ago
Job Summary: We are seeking a highly skilled and experienced Care Management Team Lead to join our team at Centene Corporation. As a key member of our care management team, you will be responsible for managing the care coordination of behavioral health members to develop and assess high-quality, cost-effective healthcare outcomes related to mental and behavioral health needs.
Key Responsibilities:
- Manage escalations and care management issues related to members or providers.
- 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 the caseloads of care management staff 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 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 care management team to improve member and provider experience and high-quality care.
- Educate and provide resources for care management team on key initiatives and member outreach to facilitate on-going communication between 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:
- Requires a Master's degree or Graduate from an Accredited School of Nursing and 5+ years of related experience.
- Licensed Clinical Behavioral Health Professional or RN based on state contract requirements, e.g., LCSW, LMSW, LMFT, LMHC, and RN with BH experience.
- Or Associated license working towards full licensure required.
What We Offer:
- Competitive pay range: $98,900.00 - $183,100.00 per year.
- Comprehensive benefits package, including 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.
About Us:
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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