Senior Contracts Manager
Datasite
Care Manager
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Remote • Arizona, Florida, Illinois, New Jersey • 🇺🇸 United States
Visit company websiteSalary
💰 $55,100 - $99,000 per year
Job Level
JuniorMid-Level
About the role
- Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members 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
- Evaluates the needs of the member via phone or in-home visits related to the resources available, and recommends and/or facilitates the care plan/service plan for the best outcome, which may include behavioral health and social determinant needs
- May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources
- Develops ongoing care plans for members with high level acuity and works to identify providers, specialists, and community resources needed for care including mental health and substance use disorders
- Coordinates as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members
- Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs
- Facilitates care coordination and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services
- Collects, documents, and maintains member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
- Provides 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
- Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
- Performs other duties as assigned. Complies with all policies and standards.
Requirements
- Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing
- 2 – 4 years of related experience
- Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC, LAC) or RN based on state contract requirements with BH experience required
- Behavorial health experience strongly preferred
- For Illinois Youth Care plan only: Graduate degree and independently licensed behavioral health clinician (e.g. LCSW, LCPC, PsyD) in Illinois or Bachelor’s Degree and IL RN licensure. Must reside in IL required
- For NJ Health Plan Only: Requires a Master's degree in Behavioral Health or Social Work and a Licensed Associate Counselor (LAC) or Licensed Social Worker (LSW) required
- For Sunshine Health (FL) Only: Employees supporting Florida's Children’s Medical Services must Hold a Master’s degree in social work or related field and have one year of related professional pediatric care experience. Employee must also hold a LCSW, LMHC or other Clinical Mental Health Professional license. May require up to 80% local travel.
- For AZ Health Plan Only: Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC, LAC) or RN based on state contract requirements with BH experience. Must reside in Arizona. required
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- a flexible approach to work with remote, hybrid, field or office work schedules
- Total compensation may also include additional forms of incentives
- Benefits may be subject to program eligibility
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
care managementbehavioral healthmental healthsubstance use disordercare coordinationtelephonic outreachdigital outreachhome visitscare plan developmentclinical symptom monitoring
Soft skills
communicationcollaborationproblem-solvingeducationfeedback provisionorganizational skillsinterpersonal skillsleadershipadaptabilityempathy
Certifications
Licensed Master's Behavioral Health ProfessionalLCSWLMSWLMFTLMHCLPCLACRNLicensed Associate Counselor (LAC)Licensed Social Worker (LSW)
