行为健康护理经理
Behavioral Health Care Manager
职位职责：为主要涉及心理健康和行为健康需求的会员开展复杂护理管理工作，提供高质量、成本效益高的医疗成果，包括与心理健康和物质使用障碍相关的个性化护理计划和教育。
关键信息：此为全远程职位，负责在肯塔基州为接受复杂行为健康服务的会员完成个案管理相关任务。工作时间为周一至周五，东部时间上午8点至下午5点。优先考虑以下申请者：（1）居住在肯塔基州或其邻近州（俄亥俄州、印第安纳州、西弗吉尼亚州或田纳西州），（2）拥有有效的肯塔基州独立执照（尤其是LCSW或LPCC），以及（3）具有个案管理和心理健康服务经验，包括严重心理疾病（SMI）或物质使用障碍。
- 通过电话或入户访问评估会员的需求，根据可用资源推荐和/或制定最佳结果的护理计划/服务计划，可能包括行为健康和社会决定因素需求
- 可能进行电话、数字、入户和其他现场访问，以评估会员需求并协调资源
- 为高急性水平的会员制定持续的护理计划，并确定护理所需的提供商、专家和社区资源，包括心理健康和物质使用障碍
- 在会员和/或家庭/照顾者、社区资源和护理团队之间进行适当协调，确保所确定的服务对会员可及
- 监测护理计划/服务计划和/或会员状况和结果，注意治疗副作用、并发症和临床症状的变化，并根据识别的会员需求对护理计划/服务计划提出建议
- 协调护理并与其他适当的提供商或专家合作，确保会员能够及时获得所需护理或服务
- 收集、记录并维护会员信息和护理管理活动，以确保符合当前州、联邦和第三方支付者的监管要求
- 向会员及其家庭提供有关程序、医疗保健提供者指示、治疗方案、转诊和医疗保障的教育，这可能包括行为健康和社会决定因素需求
- 向管理层提供反馈，提出改进机会
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Position Purpose: 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.
Key Details: This fully remote role involves completing case management related tasks for members receiving complex behavioral health services in the state of Kentucky. The schedule is Monday through Friday, 8-5 PM eastern. Preference will be given to applicants who (1) reside in Kentucky or its bordering states Ohio, Indiana, West Virginia, or Tennessee, (2) have an Active independent Kentucky licensure (especially an LCSW or LPCC) as well as (3) experience with case management and mental health services including serious mental illness (SMI) or 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.
Education/Experience: 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.
License/Certification:
· Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience required
Pay Range: $56,200.00 - $101,000.00 per year
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
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
Originally posted on Himalayas