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.
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.
Oahu Location)
- 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 Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, LPC and RN with BH experience required.
Pay Range : $54,000.00 - $97,100.00 per year
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.
Total compensation may also include additional forms of incentives.
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