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LTSS Service Care Manager - Behavioral Health

Role overview

Qualifications

  • Master's degree in Mental Health or Social Work
  • Graduate from an Accredited School of Nursing
  • 2 – 4 years of related experience
  • Licensed Behavioral Health Professional or RN based on state contract requirements

Responsibilities

  • Develops, assesses, and coordinates holistic care management activities
  • Evaluates member service needs and develops care plans/service plans
  • Acts as liaison and member advocate between the member/family, physician, and facilities/agencies
  • Maintains accurate documentation and supports the integrity of care management activities

About the company

Centene Corporation logo

Centene Corporation

Centene Corporation provides high-quality healthcare services to members in all 50 states. Since its founding in 1984, Centene has worked to transform the health of communities, one person at a time. Centene is the largest Medicaid managed care organization in the country and provides a portfolio of services to government sponsored healthcare programs. Centene believes that healthcare is best delivered locally. Our local health plans offer a range of health insurance solutions with a focus on providing accessible care to uninsured and under-insured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). Centene also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services. Centene’s hiring practices reflect the composition of the members and communities we serve, allowing us to deliver quality, culturally sensitive healthcare to millions of members. Centene employees help change the world of healthcare and transform our communities. To learn more about career opportunities with Centene, visit: https://jobs.centene.com/

Company details

Company typeXLarge
Company size10001

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Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Program/Team: Population Health – LTSS Care Management, SED Waiver

Schedule: Monday–Friday, 8:00 a.m.–5:00 p.m. No weekend or holiday coverage required.

Travel: Approximately 50% field-based travel within Kansas. Assigned members are typically located within a one-hour drive of the employee’s home.

Location: This is a field-based position open to candidates throughout Kansas. Preferred West-Central Kansas locations include Hays, Ellis, WaKeeney, Oakley, Quinter, Russell, and La Crosse.

Position Purpose: 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, 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

Education/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.

License/Certification:

For Sunflower plan only: Licensed Behavioral Health Professional or RN based on state contract requirements e.g., LMSW, LCSW, LMFT, LMHC, LPC and RN with BH experience required

Pay Range: $27.02 - $48.55 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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Marcus Rivera

Chief Revenue Officer

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