Lpc, Lcsw, Lmft, Or Rn

You could be the one who changes everything for our 26 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.

TEXAS Locations: Hiring in Dallas, Austin, Corpus Christi, Lubbock, or McAllen TX.
HYBRID - this is a work from home position, AND it requires travel to conduct behavioral health assessment IN-PATIENT facilities.
Monday - Friday: 8 am - 5 pm, No Evenings, No Weekends, No On-Call.
As a Behavioral Case Manager (STAFF), you will:
Perform duties 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.

• Comply with established referral, pre-certification and authorization policies, procedures and processes by related Medical Management staff.
• Participate in weekly rounds w/ agency staff
• Review and approve the initial and ongoing assessment and care plan to ensure requirements are met
• Communicate status of member health indicators with agency staff that can contribute the successful community living of members
• Other duties as assigned
• Coordinate service request/authorizations with UM and ensure agreement is aligned between the member, agency, and MCO
• Facilitate member linkages to MCO-based services and programs in collaboration w/ staff
• Understand and comply with NCQA guidelines and HEDIS measures.
• 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.

Education/Experience:

• Role requires strong communication, emotional intelligence, and organizational skills
• 3+ years working in local mental health or local behavioral health authority communities, in-patient or out-patient treatment centers, or behavioral health in managed care environments.
• 3+ years of direct behavioral health case management, utilization management, service coordination.
• Must be able to work independently with minimal supervision.
• Experience in psychiatric health care settings with high acuity psychiatric behavioral health conditions.
• Preferred Qualifications:
• Master's degree in relevant field (e.g. social work, counseling, psychology) OR Nursing degree (Associates, BSN, or MSN) specializing in psychiatric/mental health.
• 3+ years of direct case management, discharge planning, service coordination, or provider referral services for members with Medicaid and Medicare
• Proficient computer skills and experience working within large databases or provider information systems and Microsoft Office applications.
• Ability to manage high volume caseloads telephonically and meeting monthly case management metrics and service level agreements.
• Working knowledge of utilization review procedures, and familiarity with mental health community resources.

License/Certification: Unrestricted license as a LCSW, LPC, LMFT, or RN license in applicable state.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.