Manager, Care Management

Meridian Health Plan; Michigan; On-site; USD 100,000 - 187,000; Full time

Job summary

Join a leading health organization as a Care Manager, where you’ll manage a team focused on enhancing behavioral health outcomes for members. This pivotal role requires a valid MI RN license and substantial experience in clinical administration. You will develop policies, oversee team operations, and ensure adherence to regulatory standards, all while providing high-quality patient care. Competitive salary and comprehensive benefits await the right professional ready to make a difference in the lives of millions.

Benefits

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules

Qualifications

• Valid MI RN license required.
• 5+ years of related experience preferred.
• Experience with behavioral health management necessary.

Responsibilities

• Manage the care management team and coordination of behavioral health members.
• Oversee care management policies and ensure compliance with regulations.
• Handle escalated and complex care cases.

Skills

Leadership

Clinical Administration

Family Care Planning

Clinical Data Management

Education

Master's degree or Graduate from an Accredited School of Nursing

Tools

Care Management Documentation

Job description

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You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose Manages the care management team and the care coordination of behavioral health members to develop and assess high quality, cost-effective healthcare outcomes related to mental and behavioral health needs. Manages escalations and care management issues related to members or providers.

• Oversees and reviews care management required documentation to maintain compliance with federal and state regulations and contractual agreements
• Develops, implements, and oversees care management policies and procedures within the care management team based on regulatory requirements and industry standards
• Directs the daily activities of care management staff including reviewing and approving the caseloads of care management staff based on state requirements, care management staff experience, and member needs
• Manages escalated and complex care cases, and provides guidance to team members to address member concerns related to mental and behavioral health members
• Manages resolutions of complaints and assists in audits and evaluations related to care programs
• Develops, implements, and oversees care management programs to facilitate the use of appropriate services and resources
• Sets goals and objectives for care management team to achieve cost-effective healthcare results
• Works with care management senior management to provide updates and insights on care management team goals
• Provides feedback to care management team to improve member and provider experience and high-quality care
• Educates and provides resources for care management team on key initiatives and member outreach to facilitate on-going communication between care management team, members, and providers
• Assists care management senior leadership with onboarding, hiring, and training new care management employees, recent promotes, and transfers within the department
• Performs other duties as assigned
• Complies with all policies and standards
  
  

Ideal candidate will reside in the state of Michigan, hold a valid MI RN license with experience in leadership, family care planning, clinical administration, and clinical data management.

Education/Experience Requires a Master's degree or Graduate from an Accredited School of Nursing and 5+ years of related experience.

License/Certification

• Licensed Clinical Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, and RN with BH experience required.
  
  

Pay Range $100,900.00 - $186,800.00 per year

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. Total compensation may also include additional forms of incentives.

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

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care and Insurance

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