Job Description

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

POSITION PURPOSE:

Perform duties related to the day to day operations of the Integrated Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life for both behavioral and physical health issues. Assess members’ current functional level and, in collaboration with the member, develop and monitor the Case Management Care Plan, monitor quality of care; assisting with discharge planning, participating in special clinical projects and communicate with departmental and plan administrative staff to facilitate daily operations of the Integrated Case Management functions. Collaborate with both medical and behavioral providers to ensure optimal care for members.  

• Work telephonically with patients identified as high risk, for both behavioral and physical health issues, and their providers to identify needs, set goals and implement action steps towards achieving goals. Empower patients to help them improve their quality of life and ensure an integrated approach to address complex issues.
• Understand and comply with NCQA guidelines and HEDIS measures.
• Comply with established referral, pre-certification and authorization policies, procedures and processes by related Medical Management staff.

Qualifications

EDUCATION/EXPERIENCE:

Master’s degree in behavioral health and an unrestricted license as a LCSW, LMFT or LPC, or a PhD, PsyD. 3+ years of case and/or utilization management experience. Experience in psychiatric and medical health care settings. Working knowledge of mental health community resources.  

LICENSE/CERTIFICATION:

Unrestricted license as a LCSW, LMHC, LMSW LMFT, LPC, PhD, PsyD or  license in applicable state.

Benefits 

Our Comprehensive Benefits Package:

• Flexible work solutions including remote options, hybrid work schedules and dress flexibility
• Competitive pay
• Paid Time Off including paid holidays
• Health insurance coverage for you and dependents
• 401(k) and stock purchase plans
• Tuition reimbursement and best-in-class training and development

Additional Information

All your information will be kept confidential according to EEO guidelines.