LTSS Service Care Manager - LPC, LCSW, or LMFT

Centene; Tyler (TX); Hybrid; USD 37,000 - 67,000; Full time

Job summary

Centene is seeking a Hybrid Behavioral Health Care Manager to develop and coordinate care for members with significant mental and behavioral health needs in the Tyler, TX region. This role requires occasional travel to nearby communities with mileage reimbursement.

A master’s degree in a mental health field and an unrestricted BH license are required. You will evaluate high-risk members, advocate for patients, educate families, and coordinate services across medical and community resources while

Qualifications

• Requires a master's degree in Mental Health Counseling or Social Work.
• 2-4 years of related experience.
• Unrestricted behavioral health professional license per state requirements (e.g., LCSW, LMFT, LMHC, or LPC).

Responsibilities

• Evaluates needs of complex and high-risk members with mental/behavioral health needs and recommends a plan of care.
• Acts as liaison between member/family, physician, and facilities/agencies.
• Supports members with mental/behavioral health needs (e.g., depression, bipolar, schizophrenia, PTSD, SUD).
• Performs home or site visits to assess needs and collaborate with resources.
• Provides education to members and families on care, services, and benefits.
• Coordinates community resources and service authorization for various services.
• Ensures referrals and accessibility of services; maintains documentation in the care management system.
• Maintains compliance with clinical guidelines and regulations.
• Provides feedback to leadership on quality and cost-effective care.

Skills

Case management

Communication

Documentation

Time management

Independent work

Education

Master's degree in Mental Health Counseling or Social Work

Tools

TruCare

Microsoft Office

Excel

PowerPoint

Word

Job description

Position Purpose:

Develops, assess and coordinates holistic care management activities, with primary focus and support towards populations with significant mental/behavioral health needs, to enable quality, cost-effective healthcare outcomes. Evaluates member service needs and develops or contributes to development of care plans/service plans, and educates members, their families and caregivers on services and benefits available to meet member needs.

Key Details:

This is a Hybrid Behavioral Health Care Manager position that requires travel for member visits near Tyler, TX, Lindale, TX, Athens, TX, Hawkins, TX, Kilgore, TX, Henderson, TX, Longview, TX, Jacksonville, TX, Mabank, TX, Palestine, TX, Marshall, TX, or Sulphur Springs, TX . Mileage reimbursement is provided for travel.

REQUIRED:

An unrestricted behavioral health professional license based on state contract requirements (e.g., LCSW, LMFT, or LPC) is required for the applicable state upon application submission.

Work Schedule:

Monday - Friday: 8:00 am - 5:00 pm (CST), NO On Call, Evenings, Weekends, or Holidays.

Duties:

• Evaluates the needs of the most complex and high-risk members with mental/behavioral health needs, and recommends a plan of care for the best outcome
• Acts as liaison and member advocate between the member/family, physician, and facilities/agencies
• Supports members with primarily mental/behavioral health needs, such as those with (or a history of) major depression, bipolar disorders, schizophrenia, borderline personality disorder, post-traumatic stress disorder, substance use disorder, self-injurious behavior, psychiatric inpatient admissions, etc
• Performs frequent home and/or other site visits (once a month or more), such as to assess member needs and collaborate with resources, as required
• Provides and/or facilitates education to long-term care members and their families/caregivers on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, and healthcare benefits. Provides subject matter expertise and operational support for relevant mental and behavioral health-focused activities, such as the handling of crisis calls, mental health first aid training, field safety and de-escalation practices, psychotropic and other medication monitoring, etc
• Educates on and coordinates community resources, to include medical, behavioral and social services. Provides coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living)
• Ensures appropriate referrals based on individual member needs and supports the identification of providers, specialists, and community resources. Ensures identified services are accessible to members
• Maintains accurate documentation and supports the integrity of care management activities in the electronic care management system. Works to ensure compliance with clinical guidelines as well as current state and federal guidelines
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care 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 Mental Health Counseling or Social Work and 2 - 4 years of related experience.

License/Certification:

An unrestricted behavioral health professional license based on state contract requirements (e.g., LCSW, LMFT, LMHC, or LPC) is required and must be license in the applicable state

Preferred Experience:

• 4+ years of case management experience, preferably within child welfare systems, adoption, foster care, Child Protective Services, pediatric acute care settings or in-patient treatment facilities, schools, or local or state MHA/BHAs for youth
• Experience collaborating with medical and behavioral health providers and managing community resources for Foster Care Medicaid recipients.
• Experience managing high volume caseloads
• Field-based experience strongly preferred
• Strong clinical documentation, problem-solving, communication, attention to detail, organizational, and time management skills required.
• Ability to adapt to changing business needs with openness, flexibility, and professionalism.
• Proficient technology skills and direct experience working within web-based applications and case management systems (i.e. TruCare, Microsoft Office Site - Outlook, M365 Copilot, Excel, PowerPoint, Word, OneNote, etc).
• Must be able to work independently with minimal supervision.
• Experience working in managed care environment is a PLUS (Federal and State Sponsored Govt Programs)
• Bilingual English/Spanish skills are a plus but not required.

NOTE:

For Superior Health Plan: Department of Family & Protective Services (DFPS) background check is required.

Pay Range:

$27.02 - $48.55 per hour