护理经理（心理健康）
Care Manager (Behavioral Health)
职位职责：为主要针对心理健康和行为健康需求的会员开展复杂护理管理活动，以提供高质量、成本效益高的医疗结果，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：要求持有加利福尼亚州认证的硕士级行为健康专业执照。加利福尼亚州居民优先；需在太平洋标准时间工作。
- 通过电话或上门访问评估会员的需求，根据可用资源推荐和/或制定护理计划/服务计划，以实现最佳结果，可能包括行为健康和社会决定因素需求
- 可能执行电话、数字、上门或其他现场访问，以评估会员需求并协调资源
- 为高复杂度的会员制定持续的护理计划，并确定所需的提供者、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，确保会员能够获得已确定的服务
- 监测护理计划/服务计划和/或会员状态及结果，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
- 协调护理并与其他提供者或专家合作，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、联邦和第三方支付方监管要求
- 向会员及其家庭提供有关程序、医疗提供者指示、治疗选项、转诊和医疗保障的教育，可能包括行为健康和社会决定因素需求
- 向领导层提供反馈，提出改进和提升会员护理质量和交付效率的机会
- 完成其他指派的任务
- 遵守所有政策和标准
教育/经验：需要获得行为健康或社会工作硕士学位，或来自认证护理学校的专业学位，并具有2-4年相关工作经验。
执照/认证：
- 认证的硕士级行为健康专业人员（例如，LCSW，）
查看英文原文
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: California Licensed Master's Behavioral Health Professional required. California residency preferred; must work PST hours.
- 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
- Must be licensed in California.
Pay Range: $27.02 - $48.55 per hour
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