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.
Must reside on Oahu, HI
Position Purpose: Responsible for supervising the day to day operations of the Behavioral Health Care Managers and ensuring compliance with federal and state regulations. This role will be responsible for supporting the care management team through case file reviews and monthly audit review of the care managers.
- Supervise the daily activities of staff to promote quality improvement and efficient methods.
- Coordinate the training of care management staff and ensure staff is able to facilitate member and provider behavioral health needs.
- Work closely with network development and provider relations staff to develop and maintain the behavioral health network and ensure that it is fully integrated with the physical health provider network.
- Partner with Utilization Management staff to monitor behavioral health utilization to identify and address potential behavioral health under -or over-utilization.
- Oversee subcontracts related to behavioral health services
- Assist in recruitment efforts in accordance to the staff to member ratio
- Assign cases and oversee care management caseloads including service care plan approval and member case file reviews.
- Maintain compliance with federal and state regulations and contractual agreements.
Education/Experience: Bachelor's degree in Social Services, Psychology, Health Administration, or related field. 4+ years related experience. Working knowledge of Medicare, Medicaid and health plan administration. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
Licenses/Certifications: Current state’s LISW or PCC licensure and CCM.
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. Total compensation may also include additional forms of incentives.
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.