Remote Manager, Care Management

Centene

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Business Area: Clinical & Care Management
Job Type: Full time
Job Number: 1490880

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.

Qualified applicants must reside in Winston-Salem or Greensboro, North Carolina

Position Purpose:

Responsible for providing oversight of the Care Management team and coordination of necessary resources for members. This may include adequate clinical, behavioral, acute/chronic, and social care services.

  • Ensure staff is able to facilitate member and provider needs through entire care management cycle.
  • Manage coordination of care challenges experienced by all members of different lines of business.
  • Oversee clinical practice coaching activities to enhance service delivery for individual members, including clinical practice coaching at provider agencies through Provider Clinical Practice Coaches.
  • Identify opportunities for cost savings and improved member outcomes for members shared with other payers.
  • Promote integration of physical and behavioral health practices.
  • Manage the coordination of care and transition of care activities for individual members and their families to achieve and maintain performance standards that meet or exceed contract requirements and established target for quality and customer service.
  • Partner with internal staff on key initiatives and outreach for members as needed.
  • Implement policies and procedures through oversight for complex cases and present to management.
  • Coordinate the training of care management staff.
  • Facilitate on-going communication between care management staff and providers
  • Oversee care management caseloads and create reports to regulate compliance with federal and state regulations and contractual agreements.
  • Evaluate complex data to manage the integrated care program and develop, prepare, and present reports on the program and issues to both internal and external stakeholders.
  • Manage the daily activities of supervisory staff to promote quality improvement and efficient methods.

Education/Experience:

Bachelor’s degree in Nursing, Social Work, Health Care Administration, related field or equivalent experience. 5+ years of social work, healthcare administration, patient/community advocacy, care management, or combined care management and clinical nursing experience. 2+ years of supervisory experience in a related field.

Licenses/Certifications:

Licensed Clinical Social Worker (LCSW), Licensed Marriage & Family Therapist (LMFT), Licensed Behavioral Health Medical Practitioner, Licensed Professional Counselor, Licensed Substance Abuse Counselor, Licensed Psychologist, or Registered Nurse preferred.

For North Carolina LTSS:

Licensed LCSW or licensed RN in good standing. Experience to include 2+ years of prior LTSS and/or HCBS coordination, care delivery monitoring and care management experience. This is a hybrid position that offers the flexibility of working from home with up to 30% travel required.

Pay Range: $84,300.00 – $151,700.00 per year

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.