Senior Care Manager

Fidelis Care - New York; New York (NY); On-site; USD 73,000 - 133,000; Full time

Job summary

Fidelis Care - New York is looking for a dedicated Senior Care Manager to oversee care management activities for members, focusing on behavioral health needs. The ideal candidate will have a Master's degree, relevant licensing, and experience in healthcare coordination, providing essential services to enhance care quality for our diverse member base.

Benefits

Comprehensive benefits package

Health insurance

401K and stock purchase plans

Tuition reimbursement

Flexible work schedules

Qualifications

• Requires a Master's degree and 4-6 years of experience.
• NYS Behavioral Health and/or RN license required.
• Must reside in NY, NJ, or CT.

Responsibilities

• Develops and coordinates care management activities.
• Monitors member status and outcomes, revising care plans as necessary.
• Educates members and their families on healthcare options.

Skills

Behavioral Health Expertise

Care Coordination

Communication Skills

Problem Solving

Education

Master's degree in Behavioral Health or Social Work

NYS Behavior Health License or RN License

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 Develops, assesses, plans, implements, and coordinates complex care management activities based on member needs primarily focused on behavioral health needs (including behavioral health, and social needs) to provide quality, cost-effective healthcare outcomes. Develops a personalized care plan/service plan as appropriate/required and educates members and their families/care givers on services and benefit options available to receive appropriate high-quality care.

• Develops and continuously assesses ongoing care plans/service plans of the members with high level acuity via phone or in-home visits and works to identify providers, specialists, and community resources needed for care including mental health and social determinant needs
• May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources
• Coordinates and manages, as appropriate, between the member and/or family and the care provider team to ensure identified services are accessible to members
• Maintains a caseload with higher volume of complex/specialty cases
• Monitors member status and outcomes for changes in treatment side effects, complications and clinical symptoms and revises care plan/service plan based on member needs and issues identified including mental health and substance use disorders
• Identifies problems/barriers for care coordination and appropriate care management interventions for advanced and complex cases including mental health and substance use disorders
• Reviews member data to identify health risks and/or care gaps, and improve operating performance and quality care to address member’s needs/issues and provides recommendations in accordance with state and federal regulations
• Reviews referrals information and intake assessments to develop appropriate care plan for complex/specialty cases
• Collaborates with healthcare providers and partners (including behavioral) as appropriate to facilitate care coordination and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services
• Collects, documents, and maintains all 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
• Partners with leadership team to improve and enhance care and quality delivery for members in a cost-effective manner
• May precept clinical new hires by fostering and building core skills, coaching and facilitating their growth, and guiding through the onboarding process to upskill readiness
• Provides guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities to bridge gap between classroom training and field practice
• Engages and assists new hire/preceptee during onboarding journey including responsibility for completing competency check points ensuring readiness for Service Coordination success
• Engages in a collaborative and ongoing process with People Leaders and cross functional teams to measure and monitor readiness
• Performs other duties as assigned.
• Complies with all policies and standards.
  
  

Must reside in NY, NJ, or CT

Education/Experience Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 4 – 6 years of related experience.

NYS Behavior Health and / or RN License required

License/Certification

• Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience required
  
  

Pay Range $73,800.00 - $132,700.00 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, 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

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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