Behavioral Health Care Manager

WellCare of Kentucky; Kentucky; On-site; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off

Job summary

Centene is seeking a remote behavioral health care manager to develop and coordinate complex care plans for members with behavioral health and substance use needs in Kentucky.

The role requires a master's degree in Behavioral Health or Social Work, licensure, and 2–4 years of case management experience; schedule Monday–Friday, 8–5 ET, with preference for Kentucky residents.

Qualifications

• Master's degree in Behavioral Health or Social Work or a Nursing degree with BH experience.
• 2-4 years of related experience in case management or behavioral health.
• Active Kentucky licensure (LCSW, LMSW, LMFT, LMHC, LPC) or RN per state contract.

Responsibilities

• Evaluates member needs and designs care/service plans for behavioral health.
• Performs telephonic, digital, home, or site visits to assess needs.
• Develops ongoing high-acuity care plans and coordinates providers.
• Coordinates between member, family and care team for access.
• Monitors plans and outcomes, adjusting as needed.
• Facilitates care coordination with appropriate providers.
• Collects and maintains member data to ensure regulatory compliance.
• Provides education to members and families on procedures and benefits.
• Offers feedback to leadership to improve care quality and cost-effectiveness.
• Performs other duties as assigned; complies with policies.

Skills

Case management

Mental health services

Communication skills

Education and counseling

Education

Master's degree in Behavioral Health or Social Work

Nursing degree (accredited)

Job description

Position Purpose:

Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substance use disorder.

Key Details:

This fully remote role involves completing case management related tasks for members receiving complex behavioral health services in the state of Kentucky. The schedule is Monday through Friday, 8-5 PM eastern. Preference will be given to applicants who (1) reside in Kentucky or its bordering states Ohio, Indiana, West Virginia, or Tennessee, (2) have an Active independent Kentucky licensure (especially an LCSW or LPCC) as well as (3) experience with case management and mental health services including serious mental illness (SMI) or substance use disorder.

Responsibilities:

• Evaluates the needs of the member via phone or in-home visits related to the resources available, and recommends and/or facilitates the care plan/service plan for the best outcome, which may include behavioral health and social determinant needs
• May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources
• Develops ongoing care plans for members with high level acuity and works to identify providers, specialists, and community resources needed for care including mental health and substance use disorders
• Coordinates as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members
• Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs
• Facilitates care coordination and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services
• Collects, documents, and maintains member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs
• Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2-4 years of related experience.

License/Certification:

• Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience required

Pay Range:

$56,200.00 - $101,000.00 per year

Company Overview:

At Centene, we connect people to the care they need to live healthier lives - and the work you do here makes that impact real every day. You'll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It's work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Benefits:

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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

EEO Statement:

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.

Equal Opportunity Clarification:

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act