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Company

Superior HealthPlan

Address , Austin, 78741, Tx
Employment type FULL_TIME
Salary
Expires 2023-07-01
Posted at 1 year ago
Job Description

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.

Seeking Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage & Family Therapy (LMFT), or Registered Nurse (RN)
Hiring Locations: Austin, TX, Abilene, TX, Beaumont, TX, Harlingen, TX, Eagle Pass, TX, Laredo, TX, McAllen, TX, Orange, TX, Limestone County, TX, Waco, TX or Bosque County, TX.
Competitive Salary, Full-time Benefits, PTO, Holiday Pay, Sign On Bonus, Travel Reimbursement, WORK FROM HOME, and more!
NOTE: Applicants must be willing and able to travel to conduct behavioral health assessments IN-PERSON with members.
Position Purpose: Perform duties related to the day-to-day operations of the Service Management functions for Pediatric members to achieve the highest possible levels of functioning and wellness by ensuring consistent, timely access to medically necessary behavioral health services. Monitor quality of care, assist with discharge planning.

  • Work with Child/Adolescents Care Members, Medical Consenters, Clinical staff and providers to meet the behavioral healthcare needs of each member’s condition.
  • Travel is required to conduct behavioral health assessments
  • Identify children and adolescents' members who may benefit from service management, conduct an assessment and develop, implement and monitor a behavioral healthcare service plan.
Provide information to staff to facilitate development of the behavioral healthcare service plan.
  • Review information submitted by providers into the database to ensure material is appropriate and consistent with guidelines for data inclusion.
  • Encourage behavioral health providers to use evidence-based practices and confirm that behavioral health providers and PCP’s are sharing information as required.
  • Maintain compliance with federal and state regulations and contractual agreements.
  • Maintain HIPAA compliance.
  • Coordinate service management functions with other departmental functions.
  • Update database regularly with most recent Service Management Plan of Care.
  • Monitor data to address trends or potential quality improvement opportunities.
  • Comply with established referral, pre-certification and authorization policies, procedures and processes by related medical management staff.

Education/Experience:

  • Master's degree in relevant field (e.g. social work, counseling, psychology) OR Associates/Bachelor’s degree in Nursing specializing in psychiatric/mental health.
  • 3+ years of direct behavioral health/psychiatric experience, case management, utilization management, or service coordination

Preferred Experience:

  • Experience working with children and adolescents with special needs and/or behavioral health conditions.
  • Experience working in Field-based Case Mgt roles is preferred.
  • Experience working in psychiatric health care settings, In-patient and Outpatient, treatment facilities, school-based settings, or behavioral health community agencies - Local Mental Health Authorities
  • Working knowledge of utilization review procedures, and familiarity with mental health community resources.

License/Certification: Required to have full license as a LCSW, LMFT, LPC, or RN in the applicable state and driver’s license is required.

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.