Case Manager

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Case Manager - LPC or LCSW - utilize clinical behavioral health/case management skills to assess child and adolescent members with behavioral health conditions and coordinate approved Medicaid services.

Hiring licensed behavioral health professionals to conduct behavioral health assessments with child and adolescents via field home visits and telehealth.

As a Behavioral Health Service Manager, you will:

Perform duties related to the day-to-day operations of the Service Management functions for Foster Care members to achieve the highest possible levels of functioning and wellness by ensuring consistent, timely access to medically necessary behavioral health services. Monitor quality of care, assist with discharge planning.

• Work with Foster Care Members, Medical Consenters, Department of Family and Protective Services (DFPS) staff and providers to meet the behavioral healthcare needs of each foster care member’s condition.
• Identify foster care members who may benefit from service management, conduct an assessment and develop, implement and monitor a healthcare service plan via field home visits and/or telehealth service.
• Provide information to DFPS staff to facilitate development of the DFPS case plan.
• Update database regularly with most recent Service Management Plan of Care.
• Review information submitted by providers into the database to ensure material is appropriate and consistent with guidelines for data inclusion.
• Encourage behavioral health providers to use evidence-based practices and confirm that behavioral health providers and PCP’s are sharing information as required.
• Comply with established referral, pre-certification and authorization policies, procedures and processes by related medical management staff.
• Maintain compliance with federal and state regulations and contractual agreements.
• Coordinate service management functions with other departmental functions.
• Monitor data to address trends or potential quality improvement opportunities.
• Maintain HIPAA compliance.
 

Education/Experience:

Master's degree in behavioral health or relevant field (e.g., social work, clinical mental health counseling, clinical psychology) is required AND 3 years of case and/or utilization management experience. Experience in psychiatric health care settings, child behavioral health conditions and members with special needs. Working knowledge of utilization review procedures, and familiarity with mental health community resources.

License/Certification: unrestricted Licensed Clinical Social Worker (LCSW) or Licensed Professional Counselor (LPC) for the applicable state and driver's license is required.

Preferred Qualifications:

• Must be able to work independently with minimal supervision.

• 3 years of experience working directly with children and adolescent members with behavioral health conditions or special needs.

• 2 years of experience working in social services such as Adoption, CPS, DFPS, Foster Care, or local or state child welfare system or MHA/BHAs.

• Experience administering psychological assessments and managing high volume caseloads.

• Experience in field-based case management roles

• Experience in patient advocacy, service coordination, and familiarity with community and mental health resources for Medicaid recipients.

• Role requires strong organizational skills and customer services skills.

• Proficient computer skills and experience working within large databases or provider information systems and Microsoft Office applications.

• Experience working in managed care environment (Federal and State Sponsored Govt Programs)

For Superior Health Plan:
Department of Family & Protective Services (DFPS) background check is required.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.