LTSS Service Care Manager, Behavioral Health
Centene Corporation
LTSS Service Care Manager – Behavioral Health
Centene Corporation
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $26 - $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, to enable quality, cost-effective healthcare outcomes
- 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, PTSD, 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
- Master's degree in Mental Health or Social Work or Graduate from an Accredited School of Nursing
- 2–4 years of related experience
- Licensed Behavioral Health Professional or RN based on state contract requirements (e.g., LCSW, LPC and BH RN)
- Preferred: 3+ years of case management roles for adult populations (ages 18-65)
- 2+ years of coordinating and managing healthcare/behavioral health services and patient advocacy and education to Medicaid members
- Field-based Social Worker or Case Manager experience in inpatient behavioral health hospital, community health, outpatient mental health, substance abuse/detox recovery treatment, or state social services settings (MHAs, LIDDA) preferred
