Case Manager, Clinical

Full Time
Dallas, TX
Posted
Job description

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.

Flexibility to WORK FROM HOME and travel for field visits. Conduct behavioral health assessments IN-PERSON with members, and coordinate community and provider mental health services.

Monday - Friday, 8am - 5 pm. NO EVENINGS, NO WEEKENDS, NO ON-CALL.

Must be licensed for the state of Texas; LPC, LCSW, LMFT, or RN with psychiatric work experience.

Purpose: Perform care management duties for adult and adolescent members with serious and persistent mental illness (SPMI) including assessing, planning and coordinating all aspects of physical and behavioral health services across the continuum of care to promote quality, cost effective care. Complex Care Behavioral Health Care Manager may work with members in a behavioral health crisis, requiring crisis call management. Crisis call management involves determining member risk level and need of additional supports up to and including requesting a welfare check by local law enforcement.

  • Bi-annually assess the member’s current health status to include physical and behavioral health needs. Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems.
  • Utilize assessment skills and discretionary judgment to develop a plan of care based upon assessment with specific objectives, goals, and interventions designed to meet member’s needs and promote desired outcomes.
  • Coordinate services between Primary Care Physician (PCP), specialist including behavioral health providers and non-clinical staff as necessary to meet the complete medical, behavioral, and socio-economical needs of members.
  • Monitor referrals made to community based organizations, medical care and other services to support the member’s overall plan of care.
  • Travel for home visits is required

Education/Experience:

  • Master’s degree in relevant field (e.g., social work, clinical mental health counseling, psychology) or RN with psychiatric experience.

  • Minimum of 3 years of experience in direct behavioral health/ psychiatric experience, case management and/or service coordination.

  • Working knowledge of complex mental health conditions, high acuity psychiatric diagnoses, utilization review procedures, and familiarity with mental health community resources

  • Knowledge of utilization principles and healthcare managed care is preferred but not required.

Preferred Qualifications:

  • Experience working in BH Case Management Field-Based roles, within local or state mental health authorities or behavioral health in-patient or outpatient treatment facilities, social services, patient advocate services, or coordinating community and mental health resources for Medicaid or Medicare recipients.

Hiring in the following Dallas Counties: Arlington, Dallas, Corsicana, Irving, Kemp, Midlothian, Italy, Red Oak, Rice, Pecan Hill, or Waxahachie, TX.

License/Certification: Must hold an unrestricted license as Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), or Registered Nurse (RN) 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.

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