Behavioral Case Mgr
Company: Meridian Illinois
Posted on: January 16, 2022
You could be the one who changes everything for our 25 million
members. Centene is transforming the health of our communities, one
person at a time. As a diversified, multi-national organization,
you'll have access to competitive benefits including a fresh
perspective on workplace flexibility.
Position Purpose:Perform duties related to the day to day
operations of the Integrated Case Management functions to include
working with members identified as high risk to identify needs and
goals to achieve empowerment and improved quality of life for both
behavioral and physical health issues. Assess members' current
functional level and, in collaboration with the member, develop and
monitor the Case Management Care Plan, monitor quality of care;
assisting with discharge planning, participating in special
clinical projects and communicate with departmental and plan
administrative staff to facilitate daily operations of the
Integrated Case Management functions. Collaborate with both medical
and behavioral providers to ensure optimal care for members.
Work telephonically with patients identified as high risk, for both
behavioral and physical health issues, and their providers to
identify needs, set goals and implement action steps towards
achieving goals. Empower patients to help them improve their
quality of life and ensure an integrated approach to address
Understand and comply with NCQA guidelines and HEDIS measures.
Comply with established referral, pre-certification and
authorization policies, procedures and processes by related Medical
Additional responsibilities for LHCC (LA) for only DOJ
Each position will be the delegated agency's single point of
contact to coordinate the overall CM activities provided to the
Review and approve the initial and ongoing assessment and care plan
to ensure requirements are met
Coordinate service request/authorizations with UM and ensure
agreement is aligned between the member, agency, and MCO
Facilitate member linkages to MCO-based services and programs in
collaboration w/ agency staff
Assist members and/or agency staff w/ transportation to healthcare
Communicate status of member health indicators with agency staff
that can contribute the successful community living of members
Participate in weekly rounds w/ agency staff
Other duties as assigned
Our Comprehensive Benefits Package:
Flexible work solutions including remote options, hybrid work
schedules and dress flexibility
Paid Time Off including paid holidays
Health insurance coverage for you and dependents
401(k) and stock purchase plans
Tuition reimbursement and best-in-class training and
Education/Experience:Master's degree in behavioral health and an
unrestricted license as a LCSW, LMFT or LPC, or a PhD, PsyD or RN.
3+ years of case and/or utilization management experience.
Experience in psychiatric and medical health care settings. Working
knowledge of mental health community resources.
License/Certification:Unrestricted license as a LCSW, LMHC, LMSW
LMFT, LPC, PhD, PsyD or RN license in applicable state.
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.
Keywords: Meridian Illinois, Columbia , Behavioral Case Mgr, Other , Hull, Missouri
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