Manager, Care Management

Centene; Ohio; Remote; USD 103,000 - 191,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules

Job summary

Centene is seeking a Manager, Care Management to lead the care management team focused on behavioral health and cost-effective outcomes. The role oversees documentation, policies, and daily activities to support compliant care for members.

The ideal candidate has 5+ years of experience in behavioral health within managed care, holds a Master's degree or higher in nursing, and an RN/LCSW/LMSW/LMFT/LMHC license. This is a full-time remote opportunity in Ohio with competitive pay and benefits.

Qualifications

• Leadership experience in a health services setting.
• Graduate degree in nursing or related field.
• Licensed or eligible in one of the following: LCSW, LMSW, LMFT, LMHC, or RN with behavioral health experience.

Responsibilities

• Oversee and review care management documentation for compliance.
• Develop, implement, and oversee care management policies and procedures.
• Direct daily activities of care management staff, reviewing and approving caseloads.
• Manage escalated and complex care cases and provide guidance to the team.
• Coordinate resolutions of complaints and assist in audits and evaluations.

Skills

Leadership experience

Behavioral health background

Managed care

Education

Master's degree or RN degree

Job description

About This Role

The Manager, Care Management oversees the care management team and coordinates care for behavioral health members, focusing on high-quality, cost-effective healthcare outcomes. This role is ideal for candidates with leadership experience and a strong background in behavioral health and managed care.

Highlights

• Pay: $102,900 - $190,500/year
• Location: Remote, OH
• Brand/Division: Buckeye Medicaid
• Schedule: Full Time

What You'll Do

• Oversee and review care management required documentation for compliance.
• Develop, implement, and oversee care management policies and procedures.
• Direct daily activities of care management staff, reviewing and approving caseloads.
• Manage escalated and complex care cases, providing guidance to team members.
• Manage resolutions of complaints and assist in audits and evaluations.
• Develop and oversee care management programs to facilitate appropriate service use.
• Set goals and objectives for the care management team.
• Work with senior management to provide updates on team goals.
• Provide feedback to improve member and provider experience.
• Educate and provide resources for the care management team on key initiatives.

Requirements

• Education: Master's degree or Graduate from an Accredited School of Nursing required
• Experience: 5+ years of related experience required
• Licenses & Certifications: One of the following licenses required: LCSW, LMSW, LMFT, LMHC, or RN with behavioral health experience

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible work schedules

About Centene

Centene is a leading healthcare provider committed to delivering exceptional patient care. They connect people to the care they need to live healthier lives, making a real impact every day through meaningful challenges and a dedicated team.