Centene Corporation Behavioral Health Service - LCSW, LPC, LMFT, RN in Eagle Pass, Texas
Position Purpose: Perform duties related to the day-to-day operations of the Service Management functions for members to achieve the highest possible levels of functioning and wellness by ensuring consistent, timely access to medically necessary behavioral health services. Monitor quality of care, assist with discharge planning.
Work with Members, Medical Consenters, Medical Management, and Service Coordination staff and providers to meet the behavioral healthcare needs of each member’s condition.
Identify members who may benefit from service management, conduct an assessment and develop, implement and monitor a healthcare service plan.
Provide information to staff to facilitate development of the service coordination case plan.
Update database regularly with most recent Service Management Plan of Care.
Review information submitted by providers into the database to ensure material is appropriate and consistent with guidelines for data inclusion.
Encourage behavioral health providers to use evidence-based practices and confirm that behavioral health providers and PCP’s are sharing information as required.
Comply with established referral, pre-certification and authorization policies, procedures and processes by related medical management staff.
Maintain compliance with federal and state regulations and contractual agreements.
Coordinate service management functions with other departmental functions.
Monitor data to address trends or potential quality improvement opportunities.
Maintain HIPAA compliance.
Travel is required
Education/Experience: Master's degree in Behavioral Health. 3+ years of case and/or utilization management experience. Experience in psychiatric health care settings, child behavioral health conditions and members with special needs. Working knowledge of utilization review procedures, and familiarity with mental health community resources. Thorough knowledge of a specialized or technical field such as clinical nursing, case and/or utilization management involving knowledge plus the application of basic theory. 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.
License/Certification: Unrestricted license as a LCSW, LMFT, LMHC, LPC, PhD, PsyD or RN.
For Superior Health Only: STAR Kids - MED- SSI - Case Management
Education/Experience: Experience with child behavioral health conditions or members with special needs is required. Previous experience acting as a lead in a functional area, managing cross-functional teams on a large-scale project, or supervisory experience including hiring, training, assigning work and managing the performance of staff, preferred but not required.
Behavioral Health Service Managers are Staff Level positions and responsible for integrating into the clinical and care management teams to ensure Member’s behavioral health needs’ are fully integrated into the service delivery system.
Offering Sign On Bonus to LCSWs, LPCs, LMFTs, or RNs with behavioral health experience
This is a Field/Remote position servicing the in Del Rio, Carrizo Springs, Eagle Pass, Crystal City, or Uvalde, TX area
Candidates must have experience working in behavioral health clinical settings and managed care settings is a PLUS
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.
TITLE: Behavioral Health Service - LCSW, LPC, LMFT, RN
LOCATION: Eagle Pass, Texas
COMPANY: Medical Management
POSITION TYPE: Hourly
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