Beyond Clinical Skills: Centene’s Unique Approach to Hiring Care Managers for Children in Foster Care

 

About the Expert: Cheryl Fisher serves as Vice President of Business Development at Centene, where she leads strategy development for children in foster care and other child welfare programs. With a background as a licensed professional counselor and experience in community mental health and victim services, she brings decades of experience in supporting vulnerable children and families.

Imagine a 10-year-old child suddenly removed from her home due to neglect, placed with a foster family she's never met, carrying complex medical needs and the invisible weight of trauma. Now imagine the foster parents trying to navigate unfamiliar healthcare systems, understand this child's medical history, and coordinate with multiple providers — all while helping the child adjust to a new home.

This scenario plays out many times across America each year. What makes the difference between a fragmented, frustrating experience and one that supports healing? Often, it's a specially trained professional who understands both healthcare systems and the unique needs of children in foster care, explains Cheryl Fisher, Vice President of Business Development at Centene, the nation’s largest provider of Medicaid managed care for children in foster care.

"Care management is the heart and soul of our program," said Fisher. "Our dual expertise in child welfare and health care uniquely positions us as an empathetic partner."

But finding the right individuals for this critical role requires a deliberate approach that goes beyond traditional case management hiring practices.

The Unique Skillset Required

When most healthcare organizations hire care managers, they typically look for clinical backgrounds and care coordination experience. For the population in foster care, this baseline isn't enough.

"We are really intentional about how we hire for our care managers," Fisher explains. "We look for people who not only have the appropriate behavioral health and physical health experience from a clinical perspective, but we want to also make sure they've worked within the foster care system too."

This expertise requirement is crucial because children in foster care navigate two complex systems simultaneously: child welfare and healthcare. A care manager must understand how placement decisions impact healthcare access, how trauma affects behaviors, and how to coordinate with child welfare agencies that may control healthcare decisions.

Key Qualifications for Care Managers for Children in Foster Care

• Clinical expertise in physical and behavioral health
• Previous experience within the foster care system
• Understanding of trauma-informed approaches
• Ability to coordinate across multiple systems

This specialized knowledge becomes particularly important when children move between placements —  a common occurrence that can disrupt healthcare continuity.

"When children move, that often means they need to connect with new providers, they're going to a different school, they have different caregivers," Fisher notes.

Care managers with foster system experience understand these transitions and can maintain continuity when other relationships change.

Lived Experience: The X-Factor

Perhaps the most distinctive element of Centene's approach to hiring care managers is the emphasis on personal connection to the foster care world.

"Sometimes it's bringing in people with lived experience," Fisher shares. "We have a lot of foster and adoptive parents who serve as care managers."

This firsthand understanding transforms the care manager role from a clinical function to a deeply empathetic partnership. Foster parents who become care managers have sat on both sides of the conversation — they've been the frustrated caregiver trying to obtain medical records at midnight and the professional trying to explain complex systems to overwhelmed families.

This perspective allows them to anticipate challenges before they arise. They understand that a foster parent may need extra support explaining a child's medication routine to teachers or might need guidance on whether certain behaviors warrant emergency psychiatric evaluation or represent normal adjustment to a new placement.

The value of this lived experience extends beyond day-to-day interactions. These care managers bring credibility when training staff and providers, grounding theoretical concepts in real-world application.

Training for Success

Even with the right background, all Centene care managers receive specialized training to support their work with this vulnerable population.

At the core of Centene’s training is a trauma-informed approach — recognizing that nearly every child in foster care has experienced some form of trauma, whether from the circumstances leading to removal or from the removal process itself.

The training emphasizes how trauma affects brain development, behavior, and healthcare engagement. Our care managers learn to recognize when a child's "non-compliance" with medical recommendations might actually represent a trauma response requiring adjustment to the care approach.

Importantly, Centene shares this knowledge beyond the internal staff.

"We're making sure that all of our staff are trained in trauma-informed care, but also extending that to our provider community too," Fisher said.

This creates a more supportive ecosystem around the child, where healthcare providers understand the unique context of foster care.

Real-World Impact

The specialized care managers serve as navigational guides through complex systems, but their impact goes far beyond paperwork and referrals. "Their role is really to walk alongside that child and the family to make sure that they get all the healthcare services that they need and that we're supporting them through those transitions as well," Fisher explains.

• Educating foster parents about specific diagnoses and how they present in children with trauma
• Helping caregivers implement treatment plans in real-world settings
• Ensuring medical information follows children when placements change
• Preventing duplication of services or contradictory treatment approaches
• Supporting permanency goals, whether reunification or adoption
• Connecting foster families with specialized training and support groups

These activities lead to measurable improvements in healthcare outcomes. Centene has documented increased compliance with well-child visits and immunizations, decreased inpatient psychiatric admissions, and more appropriate medication management for children served through these specialized care management programs.

Looking Forward: A Model for Complex Populations

The specialized care management approach developed for foster care populations offers lessons for serving other vulnerable groups with complex needs. By intentionally hiring professionals with both clinical expertise and child welfare system-specific knowledge, managed care organizations can build teams that truly understand the challenges facing the populations they serve.

As policymakers consider approaches to improve healthcare outcomes for vulnerable children, Centene’s model for care management for children in foster care reinforces the value of specially qualified staff who can bridge systems, support families, and ultimately improve outcomes for these children facing extraordinary challenges.