Behavioral Health Clinical Care Manager - REMOTE

Centene; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Centene is seeking a Behavioral Health Clinical Care Manager to enhance service delivery to members. This role requires a master's degree in behavioral health, with strong experience in crisis management and utilization management. You will handle calls, conduct assessments, and ensure members receive appropriate behavioral health services, all while enjoying flexible working options.

Benefits

Flexible work solutions including remote options

401(k) and stock purchase plans

Tuition reimbursement

Health insurance for dependents

Paid time off including holidays

Qualifications

• Master’s degree required with 3+ years of behavioral health experience post-degree.
• Prior managed care experience preferred.
• Experience with healthcare databases preferred.

Responsibilities

• Handle inbound and outbound member and provider calls.
• Perform utilization management and authorization determinations.
• Triage crisis calls and coordinate services.

Skills

Behavioral Health Assessment

Crisis Management

Utilization Management

Education

Master’s degree in behavioral health

Job 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.

100% Remote Work flexibility to work from home in Texas.

Requirement: Must have an active and current unrestricted license: LCSW, LPC, LMFT, LPCC, or be a licensed PhD for the state of Texas.

LPC - Associate, License Master Social Worker (LMSW), and RN are NOT eligible for this position.

As a Behavioral Health Clinical Care Manager (STAFF Level), you will:

• Handle inbound and outbound member and provider calls on a clinical phone queue. Ensure members receive behavioral health services appropriate to clinical need. Triage crisis calls to assist with stabilization and access to emergency evaluation. Coordinate services with other departments, such as medical case/care management. Perform utilization management functions, including authorization determinations and care shaping.
• Handle member calls, performing activities such as telephonic clinical assessment, determining appropriate level of care and services, and answering benefit questions.
• Perform utilization review functions with behavioral health providers, including care shaping and authorization determinations.
• Responsible for utilization management activities with providers and/or member calls, depending on team.
• Triage crisis calls, providing in-the-moment support and assisting with access to emergency services.
• Use established protocols, as well as clinical judgment, to evaluate and problem solve during interactions with members and providers.
• Document all calls and activities within a data management system and access multiple databases for benefit and workflow information.
• Enhance clinical knowledge and skills by actively participating in all assigned training and staff meetings.

Education/Experience

Master’s degree in behavioral health and 3+ years of behavioral health experience (at least 2 years post-Master's degree). Prior managed care experience preferred. Prior experience with multiple system applications and electronic data entry, including call center and/or healthcare databases preferred.

License/Certification

Must have an unrestricted license for TEXAS: Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT), or Licensed Psychologist (PhD).

LPC - Associate, License Master Social Worker (LMSW), and RN are NOT eligible for this position.

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 top-tier training and development.

About the company

Centene Corporation is a publicly traded managed care company based in St.

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