Remote Behavioral Health Care Manager

Centene Corporation; United States; Remote; USD 103,000 - 191,000; Full time

Job summary

Centene Corporation is seeking a remote Manager, Care Management to lead the care management team overseeing behavioral health members and ensure high-quality, cost-effective outcomes.

The role requires an active clinical license in Ohio and a master’s degree or nursing degree with 5+ years of related experience; strong leadership, communication, and regulatory knowledge are essential. You will work with clinicians, providers, and senior management to implement policies and manage escalations.

Qualifications

• Requires a Master’s degree or Graduate from an Accredited School of Nursing and 5+ years of related experience.

Responsibilities

• Oversees and reviews care management 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

Skills

Leadership

Behavioral Health

Managed Care

Case Management

Utilization Review

Communication Skills

Presentation Skills

Education

Master’s degree

Nursing degree graduate

Job description

Centene Corporation is seeking a remote Manager, Care Management to lead the care management team overseeing behavioral health members and ensure high-quality, cost-effective outcomes.

The role requires an active clinical license in Ohio and a master’s degree or nursing degree with 5+ years of related experience; strong leadership, communication, and regulatory knowledge are essential. You will work with clinicians, providers, and senior management to implement policies and manage escalations.