Care Manager
职位目的：为主要的精神和行为健康需求成员开发，评估和促进复杂护理管理活动，以提供高质量，经济效益的医疗保健成果，包括针对心理健康和药物使用障碍相关的个性化护理计划和教育。关键细节：这是一个远程职位；然而，申请人必须居住在堪萨斯州。候选人必须持有活跃的许可证士行为卫生专业执照 （例如 LCSW,LMSW,LMFT,LMHC 或 LPC）或满足具有行为健康经验的 RN 要求。理想的候选人将拥有强大的行为健康临床知识和评估技能，以及优秀的沟通和客户服务技巧。与排放计划，解决问题，护理协调，计算机系统，组织管理，时间管理以及与多学科团队合作的经验是最受欢迎的。工作日程是周一到星期五，早上8点至下午5点。·通过电话或家庭访问来评估成员的需求，并推和/或促进护理计划/服务计划以获得最佳结果，这可能包括行为健康和社会决定性需求 · 能够通过电话，数字，家庭和/或其他网站访问来评估成员的需求并与资源合作 · 为高水平的成员制定持续护理计划，并确定提供商，专家以及社区资源，包括精神健康和药物使用障碍在内的护理所需；· 适当地协调成员和/或家庭/照顾者，社区资源和护理人员团队以确保已识别的服务可供成员获得。·监督护理计划/服务计划和/或成员身份以及治疗副作用，并发症和临床症状的变化结果，并根据确定成员需求提供建议的护理计划 /服务计划 · 促进护理协调，与适当的供应商或专家合作以确保成员及时获得所需的护理或服务 ·收集，文件，并维护员工信息和护理管理活动以确保遵守现行州，联邦和第三方支付机构的规定 · 提供成员及其家人有关程序，医疗保健提供者的指示，治疗选择，转让和医疗福利的教育
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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 is a remote position; however, applicants must reside in Kansas. Candidates must hold an active Licensed Master’s Behavioral Health Professional license (e.g., LCSW, LMSW, LMFT, LMHC, or LPC) or meet RN requirements with behavioral health experience. The ideal candidate will have strong behavioral health clinical knowledge and assessment skills, along with excellent communication and customer service skills. Experience with discharge planning, problem-solving, care coordination, computer systems, organizational management, time management, and working with multidisciplinary teams is highly preferred. The work schedule is Monday through Friday, 8:00 AM to 5:00 PM
- 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