Description
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
- Develop, assess and adjust, as necessary, the care plan and promote desired outcome
- Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
- Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
- Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
- Provide patient and provider education
- Facilitate member access to community based services
- Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
- Actively participate in integrated team care management rounds
- Identify related risk management quality concerns and report these scenarios to the appropriate resources
- Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
- For Michigan Complete Health and DE First Health- home visits required
Licenses/Certifications: Current state’s LMSW or LCSW license.
Washington Licenses/Certifications: LMSW, LMHC or LCSW license or RN with Behavioral Health experience. Chemical Dependency Professional (CDP) certification preferred.
For Arizona complete Health Complete Care Plan:
Licenses/Certifications: Arizona Licensed Clinical Social Worker (LCSW), Arizona Licensed Marriage & Family Therapist (LMFT), Arizona Licensed Professional Counselor (LPC), Arizona Licensed Master Social Worker (LMSW) or Licensed Associate Marriage & Family Therapist (LAMFT), Licensed Associate Counselor (LAC) or Licensed Associate Master Social Worker (LAMSW) license required.
Pediatrics assignments - experience in pediatrics (clinical acute care, community or managed care setting) is preferred
Obstetrics (OB) assignments - RN experience in OB (clinical, acute, community or managed care setting) is preferred
For Fidelis Care only: NYS unrestricted license as Licensed Marriage and Family Therapist (LMFT) , Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW), Licensed Mental Health Counselor (LMHC) or Registered Nurse (RN) License. Master's degree required with Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW) or Licensed Mental Health Counselor (LMHC).
For Michigan Health Plan: Licensed Bachelor's prepared social worker, limited license Bachelor's prepared social worker, limited license Master's prepared social worker, or licensed Master's prepared social worker. Valid driver's license required.
For New Hampshire Healthy Families: Candidates with an active social work license in good standing in other states than NH, must obtain the NH equivalent within 90 days of hire. Active driver’s license in good standing preferred.
For Magnolia Only:
Education/Experience: Graduate from an Accredited School of Nursing or Bachelor’s degree in Social Work. 2+ years of clinical nursing or social work/behavioral health experience in a clinical, acute care or community setting. Knowledge of government sponsored managed care programs preferred.
Licenses/Certifications: MS unrestricted license as Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage & Family Therapist (LMFT) or Registered Nurse (RN) License. Master's degree required with Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), or Licensed Marriage & Family Therapist (LMFT). Valid MS Driver’s License Required.
For Sunshine Health (FL): An RN, LCSW, LMSW, LMHC or other Mental Health Professional license is required. Employees supporting Florida's Children’s Medical Services (CMS) must have one of the above professional licenses and 1. Minimum of two years of pediatric experience for Florida licensed registered nurses, or 2. Hold a Master’s degree in social work or related field and have one year of related professional pediatric care experience. May require up to 80% local travel.
For Kentucky only: Licenses and certifications include LCSW, CSW, LPCC or LMFT.
For Shared Services: Clinical licensure for multiple states is required
For Illinois Health Plan only: Required A Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position. Required: Unrestricted license as Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW), Licensed Clinical Professional Counselor (LCPC), Licensed Marriage & Family Therapist (LMFT) or Registered Nurse (RN) License.
DE First Health: Master’s degree and LMSW or LCSW license required
For Missouri, Home State Health only: License/Certification: Required A Master's Degree in Social Work, Psychology, Counseling, Rehabilitation, or other relevant field that provides a foundation to receive a license as required of the position. Required: Unrestricted license as Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), or Registered Nurse (RN) License with behavioral health experience.
For Oklahoma Complete Health Only: Health a Bachelor’s degree in social work, psychology, or a related social services field; OR licensed clinical social worker with a license to practice in the State of Oklahoma. Must successfully complete the Behavioral Health Case Manager certification training provided through the Department of Mental Health and Substance Abuse Services within (6) months of date of hire.
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
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.
