Senior Behaviorial Health Program Manager
Remote-MI, United States
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
- Implement behavioral health operational priorities and manages resources to operational goals and budgets.
- Project leads behavioral health and/or behavioral health home program development and integration activities both internally and externally.
- Improves quality of behavioral health product by driving cross functional initiatives.
- Establish, maintain and foster professional working relationships with all behavioral health providers and develops regular and ongoing working relationship with the community mental health system in the market- including community mental health centers, treatment facilities and other significant behavioral health providers in the market.
- Utilizes data to identify and manage change necessary to achieve performance improvement.
- Communicates and educates associates on behavioral health strategy.
- Develops behavioral health clinical educational materials, and performs provider behavioral health education.
- Works to develop and enhance relationships within the provider community, including behavioral health homes, community mental health centers, hospitals and individual providers (BH Providers and PCP's) and groups identified that are participating in Physical/ Behavioral integration activities.
- Designs, develops and implements behavioral health related clinical training for associates and providers.
- Works with utilization, case and disease management teams to implement and operationalize BH/PH integration initiatives.
- Educates health plan leadership and cross functional staff on behavioral health and integration strategy ensuring all entities understand and support the initiatives.
- Produces professional presentations and training materials to be utilized for training of providers and associates.
- Manages behavioral health specific policy and procedure development, clinical program descriptions, and other related documentation requirements.
- Assists with behavioral health provider and/or home provider audits as needed.
- Assists with analysis of behavioral health utilization data, KPI review and monitoring of behavioral health utilization management metrics. Participates with development of corrective action plans and associated activities for areas that need improvement.
- Performs duties and responsibilities as assignedAdditional Responsibilities: * Assist behavioral health home candidates to prepare their organization for becoming Patient-Centered Specialty Practice (PCSP) recognized through NCQA.
- Oversees compliance with behavioral health home contracts and standards.
This position is open to candidates in MI and nationwide. Candidates outside of MI applying for this role must have a clinical license for MI.
Preferred A Master's Degree in counseling, social work, psychology, nursing, or related human service fieldCandidate Experience: Required 5+ years of experience in behavioral health, preferably in public sector
Preferred Other Managed care experience Licenses and Certifications: A license in one of the following is required: Required Licensed Clinical Mental Health Counselor (LCMHC)
Licensed Professional Counselor (LPC)
Required Advanced Practice Registered Nurse (APRN)
Required Licensed Clinical Marriage & Family Therapist (LCMFT): Required Licensed Clinical Social Worker (LCSW)
Required Licensed Registered Nurse (RN)
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.
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
Job Profile
Competitive benefits Competitive pay Comprehensive benefits Comprehensive benefits package Flexible approach Health insurance Holidays Paid Time Off Stock purchase Stock purchase plans Tuition reimbursement Workplace flexibility
Tasks- Assist with policy and procedure development
- Compliance
- Develop behavioral health program strategies
- Facilitate clinical training programs
- Manage integration projects
- Support market leadership needs
Analysis Audits Behavioral health Clinical Criteria Clinical Training Compliance Corrective action plans Cross-functional Collaboration Data analysis Documentation Education Health education Health Insurance Health management Health Services Insurance Leadership Managed Care Managed care experience Management Medical management Mental Health Monitoring Nursing Performance Improvement Policy Development Product Development Program development Project Management Provider education Psychology RN Social Work Teams Training Training Programs Utilization management Workflow Design
Experience5 years
EducationAS Bachelor's Bachelor's degree Bachelor's degree in counseling Bachelor’s Degree in Nursing Bachelor's degree in psychology Bachelor's degree in related human service field Bachelor’s Degree in Social Work Education Insurance Master's Master's degree Nursing Psychology RN Social Work
CertificationsAPRN Clinical license LCSW Licensed clinical marriage & family therapist Licensed clinical mental health counselor Licensed Clinical Social Worker Licensed Professional Counselor Licensed Professional Counselor LPC Licensed registered nurse LPC Registered Nurse 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