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Behavioral Health Service Mgr - Remote Texas

Company: Superior HealthPlan
Location: Bruni
Posted on: January 11, 2022

Job Description:

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, youll 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 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 Medical Consenters, staff and providers to meet the behavioral healthcare needs of each members 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 behavioral healthservicecase 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 PCPs 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.Our Comprehensive Benefits Package:
    • Flexible work solutions including remote options, hybrid work schedules and dress flexibility
    • Competitive pay
    • 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 development
    • In-person and virtual training following State and Community guidelinesAbout Centene:
      • We are an industry leader with a local focus and a global vision:
      • We are a diversified, multi-national, inclusive healthcare company delivering relevant, technology-driven solutions at the global, national, and local levels
      • Listed on Fortune magazines Worlds Most Admired Companies List for 2nd consecutive year
      • National footprint across all 50 states, serving 1 in 15 individuals in the U.S.
      • Recognized as one of the Best Places to Work by the Human Rights Campaign FoundationEducation/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.License/Certification: Unrestricted license as a LCSW, LMFT, LPC, or RN is required.TEXAS: SUPERIOR HEALTH STAR KIDS CASE MGTSeeking candidates with 2+ years working with pediatric members with behavioral conditions or special needs.Once we are authorized to resume in-person member visits, thisField Care Manager position works remotely from home and travels to conduct member assessments.NOTE: This is a FIELD/REMOTE position. Seekingcandidates in Cameron, TX OR Laredo, TX. Travel is requiredonce we are authorized to safely travel and conduct member assessments in-person, post COVID restrictions. Mileage Reimbursement is available for travel.DFPS background check requiredCentene 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: Superior HealthPlan, Laredo , Behavioral Health Service Mgr - Remote Texas, Healthcare , Bruni, Texas

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