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Care Manager
| Company | Centene |
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| Location | Ellis, KS, USA |
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| Salary | $55100 – $99000 |
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| Type | Full-Time |
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| Degrees | Master’s |
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| Experience Level | Mid Level |
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Requirements
- Requires a Master’s degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2 – 4 years of related experience.
- Licensed Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, LPC and RN with BH experience required.
Responsibilities
- 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.
Preferred Qualifications
- Experience working with foster care and the Department for Children and Families (DCF) is desirable.
