Assurance Manager – Industrial Goods
RSM US LLP
LTSS Service Care Manager – Behavioral Health
Centene Corporation
full-time
Posted on:
Location Type: Office
Location: Dallas • Texas • 🇺🇸 United States
Visit company websiteSalary
💰 $27 - $48 per hour
Job Level
JuniorMid-Level
About the role
- Develops, assesses and coordinates holistic care management activities, with primary focus and support towards populations with significant mental/behavioral health needs
- Evaluates member service needs and develops or contributes to development of care plans/service plans, and educates members, their families and caregivers on services and benefits available to meet member needs
- Evaluates the needs of the most complex and high risk members with mental/behavioral health needs, and recommends a plan of care for the best outcome
- Acts as liaison and member advocate between the member/family, physician, and facilities/agencies
- Supports 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
- Performs frequent home and/or other site visits (once a month or more), such as to assess member needs and collaborate with resources, as required
- Provides and/or facilitates 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
- Provides 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
- Educates on and coordinates community resources, to include medical, behavioral and social services
- Provides coordination of 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)
- Ensures appropriate referrals based on individual member needs and supports the identification of providers, specialists, and community resources
- Ensures identified services are accessible to members
- Maintains accurate documentation and supports the integrity of care management activities in the electronic care management system
- Works to ensure compliance with clinical guidelines as well as current state and federal guidelines
- Provides 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
- Performs other duties as assigned
- Complies with all policies and standards
Requirements
- Must be licensed as a LCSW, LPC, or RN with Psychiatric In-patient experience
- Requires a Master's degree in Mental Health or Social Work or Graduate from an Accredited School of Nursing and 2 – 4 years of related experience
- Preferred Experience: 3+ years of behavioral health case management, care coordination, discharge planning with adult populations (ages:18 - 65)
- 2+ years of experience coordinating and managing healthcare/behavioral health services and personal assistance/social services, and providing patient advocacy and education to members
- Experience in FIELD-BASED Social Worker or Case Managers role in-patient or out-patient behavioral health hospital, community mental health, substance abuse/ detox recovery treatment, managed care behavioral health, or state social services settings (MHAs, LIDDA)
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
care managementbehavioral health case managementcare coordinationdischarge planningpatient advocacymental health first aidcrisis interventionpsychotropic medication monitoringservice authorizationdocumentation in electronic care management system
Soft skills
communicationcollaborationadvocacyeducationproblem-solvingleadershiporganizational skillsinterpersonal skillsempathyde-escalation practices
Certifications
LCSWLPCRN
