Care Management Team Lead

5 days ago

Jefferson City, Missouri, United States Centene Corporation Full time
About the Role

As a Care Management Team Lead at Centene Corporation, you will have the opportunity to make a meaningful impact on the lives of our 28 million members. We are seeking a highly skilled and experienced professional to lead our care management team and drive high-quality, cost-effective healthcare outcomes related to mental and behavioral health needs.

Key Responsibilities
  • Manage the care management team and oversee the care coordination of behavioral health members to develop and assess high-quality, cost-effective healthcare outcomes.
  • Manage escalations and care management issues related to members or providers, ensuring timely and effective resolution.
  • 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, providing 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
  • Must be based in the state of Missouri.
  • Hold one of the following licenses: LCSW, LMSW, LMFT, LMHC, or RN with experience in behavioral health.
  • Have at least two years of leadership experience.
Education/Experience

Requires a Master's degree or Graduate from an Accredited School of Nursing and 5+ years of related experience.

License/Certification

Licensed Clinical Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, and RN with BH experience required.

Pay Range

$98,183,100.00 per year.

About Centene Corporation

Centene Corporation 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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