You could be the one who changes everything for our 26 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.

Need Licensed Case Managers in Abilene, TX, Amarillo, TX Austin, TX, Dallas, TX, Irving, TX, Grand Prairie, TX, Corsicana, TX Corpus Christi, TX, and Waco, TX

LPC, LCSW, or RN with psychiatric experience to provide telephonic case management services for adult population AND occasional travel is required in IN- PATIENT facilities.

Monday - Friday: 8 am - 5 pm, No Evenings, No Weekends, No On-Call or After Hours. Must be available to travel to IN- PATIENT facilities as needed.

As a Behavioral Case Manager (STAFF), you will:

Perform duties 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.

• 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 complex issues.
• Understand and comply with NCQA guidelines and HEDIS measures.
• Comply with established referral, pre-certification and authorization policies, procedures and processes by related Medical Management staff.
• 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/ staff
• 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

Education/Experience:

• Master's degree in relevant field (e.g. social work, counseling, psychology) OR Nursing degree (Associates, BSN, or MSN) specializing in psychiatric/mental health.

• 3+ years of direct behavioral health case management, utilization management, service coordination.

• Experience in psychiatric health care settings with high acuity psychiatric behavioral health conditions.

• Working knowledge of utilization review procedures, and familiarity with mental health community resources.

• Preferred Qualifications:

• 3+ years working in local mental health or local behavioral health authority communities, in-patient or out-patient treatment centers, or behavioral health in managed care environments. OR

• 3+ years of direct case management, discharge planning, service coordination, or provider referral services for members with Medicaid and Medicare

• Must be able to work independently with minimal supervision.

• Role requires strong communication, emotional intelligence, and organizational skills

• Ability to manage high volume caseloads telephonically and meeting monthly case management metrics and service level agreements.

• Proficient computer skills and experience working within large databases or provider information systems and Microsoft Office applications.

License/Certification: Unrestricted license as a LCSW, LPC, LMFT, or RN license in the applicable state. Driver's license is required

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.