Care Manager
Remote-IL, United States
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.
This position is a Hybrid position with a 25% travel in Cook County!
Centene is hiring a Care Manager for our Illinois Health Plan for our Youth care program. The ideal candidate will have a Behavioral Health clinical License, knowledge of care coordination and foster care, DCF.
Must reside in one of the following zip codes:
60601,60602, 60603, 60604, 60605, 60606, 60607, 60608, 606010, 60611, 60612, 60613, 60614, 60618, 60622, 60624,60625, 60626, 60631, 60634, 60639, 60640, 60641, 60642, 60644, 60645, 60646, 60647, 60651, 60654, 60656, 60657, 60659, 60660, 60661, 60666, 60668, 60670, 60673, 60674, 60675, 60677, 60678, 60680, 60681, 60682, 60684, 60685, 60687, 60688, 60690, 60691, 60693, 60694, 60699, 60701
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.
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 …
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25% travel Holidays Hybrid position
Benefits/Perks401(k) Competitive benefits Competitive pay Comprehensive benefits Comprehensive benefits package Flexible approach Flexible work options Health insurance Holidays Hybrid work Paid Time Off Stock purchase Stock purchase plans Tuition reimbursement Workplace flexibility
Tasks- Assess member needs
- Compliance
- Coordinate care services
- Develop care plans
- Educate members and families
- Ensure compliance
- Monitor treatment outcomes
Access Behavioral health Benefits Care Coordination Care management Care Plan Development Care Plans Clinical Community Resources Complex Care Management Compliance Compliance Documentation Digital Outreach Education Flexibility Foster care Healthcare Healthcare benefits Healthcare outcomes Health Insurance Health Plan Home visits Insurance Leadership Management Member education Mental Health Nursing Outreach Personalized care plans Procedures Referrals RN Service plans Social Work Substance use Substance Use Disorder Substance Use Disorders Telephonic Outreach Treatment options
Experience2-4 years
EducationAS Degree in behavioral health Degree in nursing Education Healthcare Insurance Management Master's Master's degree Nursing Related Field RN Social Sciences Social Work
CertificationsClinical license LCSW Licensed behavioral health professional LMFT LMHC LMSW LPC RN
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9