Company

Centene Corporation

Description

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.

Position Purpose Authorize and/or review utilization of mental health and substance abuse services provided in inpatient and intermediate care settings. Assure appropriate levels of care and medical necessity in a manner that supports the recovery process

Identify placement settings that offer the lowest level of restriction and greatest level of autonomy for the members based upon medical necessity

Monitor quality of care and collect and analyze utilization data

Serve as a resource and liaison between the health plan, behavioral providers, facilities, member and families

Provide and/or review member intakes and initial evaluations

Comply with performance measures in regards to denials, higher level of care admission certifications and concurrent review timeliness

Develop and maintain collaborative relationships with providers and educate on levels of care

Interact with physicians, social workers, providers, case managers, and family members to develop discharge plans and oversee their implementation

Education/Experience Bachelor’s degree in related field or equivalent experience. Master’s degree preferred. 3+ years of utilization management or clinical supervision experience in a behavioral health setting. Proficient in Microsoft Applications. Previous experience documenting in Case Management or Utilization Management systems.

Licenses/Certifications Must have a license to practice independently, and/or have obtained the state required licensure as outlined by the specific state. This includes but is not limited to licenses such as LPC, LCSW, LMFT, LMHC, LIMHP, and RN.

LCSW, LMFT, LPC, LISAC, or RN licensed in Arizona required. AZ Independent Behavioral Health License 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.

Identifier

267a179ad8a83e952db727f7a4c9cc6c