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.
- Work with Foster Care Members, Medical Consenters, Department of Family and Protective Services (DFPS) staff and providers to meet the behavioral healthcare needs of each foster care member’s condition.
- Identify foster care members who may benefit from service management, conduct an assessment and develop, implement and monitor a healthcare service plan.
- Update database regularly with most recent Service Management Plan of Care.
- 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.
- Comply with established referral, pre-certification and authorization policies, procedures and processes by related medical management staff.
- Maintain compliance with federal and state regulations and contractual agreements.
- Coordinate service management functions with other departmental functions.
- Monitor data to address trends or potential quality improvement opportunities.
- Maintain HIPAA compliance and travel is required to conduct behavioral health assessments in-person with members
- Master's degree in relevant field (e.g. social work, counseling, psychology) specializing in psychiatric/mental health.
- 3+ years of direct behavioral health/psychiatric experience, case management, utilization management, or service coordination
- Must be able to work independently with minimal supervision.
- 3+ years' experience with pediatric conditions, patients with special needs, social services for children, school-based settings, DFPS or child welfare system and/ or 3+ years working in local or state mental health authorities.
- Experience working in BH Field-Based roles, within social services, patient advocate services, or service coordination experience with community and mental health resources for child/adolescent members and Medicaid recipients.
- Experience administering psychological assessments and managing high volume caseloads is preferred.
- Role requires strong organization and customer services skills
- Proficient computer skills and experience working within large databases or provider information systems and Microsoft Office applications.
Identifier
c46e832580cadb9111f7459277077bef
Show More
Ready to join the team? We'd love to have you!