Care Manager (Behavioral Health)

Fidelis Care - New Jersey; New Jersey; Remote; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible remote/hybrid/field or office

Job summary

Centene, a national health care company, is seeking a remote Care Management Specialist focused on behavioral health for members in New Jersey. The role requires residing in Essex or Morris County or nearby border counties and involves up to 50% local travel, with an active New Jersey license required.

Responsibilities include evaluating member needs via phone or in-person visits, developing care plans, coordinating with providers and community resources, monitoring outcomes, and educating

Qualifications

• Requires Master’s degree in Behavioral Health or Social Work or Nursing degree.
• Licensed Master Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience.
• For NJ Health Plan Only: Requires a Master’s degree in Behavioral Health or Social Work and a Licensed Associate Counselor (LAC) or Licensed Social Worker (LSW) required

Responsibilities

• Evaluates member needs via phone or in-home visits and develops care plans/service plans.
• May perform telephonic, digital, home and/or other site visits outreach to assess member needs.
• Develops ongoing care plans and coordinates with providers, specialists, and community resources.
• Coordinates between member/family/caregivers and care team to ensure services are accessible.
• Monitors care plans and outcomes and provides recommendations based on member needs.
• Facilitates care coordination to ensure timely access to services.
• Collects and maintains member information to ensure regulatory compliance.
• Provides education to members and families on procedures, options, and benefits.
• Provides feedback to leadership on opportunities to improve care and quality delivery.
• Performs other duties as assigned.

Skills

Care coordination

Behavioral health

Telephonic outreach

Communication

Education

Master's degree in Behavioral Health or Social Work

Nursing degree (RN) with BH experience

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 is a remote position serving members in Essex and Morris Counties, New Jersey, with up to 50% local travel required. Candidates must reside in Essex or Morris County, or in a nearby bordering county, and the closest company office is located in Iselin, NJ. The schedule is Monday through Friday, 9:00 AM to 5:00 PM. An active New Jersey license is required for this role.

• 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.

• Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience required
• For NJ Health Plan Only: Requires a Master's degree in Behavioral Health or Social Work and a Licensed Associate Counselor (LAC) or Licensed Social Worker (LSW) required

Pay Range: $56,200.00 - $101,000.00 per year

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.

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.

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.

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