Job Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

****NOTE: This is mostly remote role provides care coordination services to DCFS Youth-In-Care and Former Youth-In-Care (ages 0-21) with less than 10% travel for rare home visits and quarterly in-person team meetings in the territory listed below. Preference will be given to applicants with past experience working with traumatized/abused youth and/or DCFS and who reside in one of the following southern Illinois counties: Madison, Bond, Fayette, Effingham, Jasper, Crawford, Lawrence, Richland, Clay, Marion, Washington, Clinton, St Clair, Monroe, Randolph, Perry, Jefferson, Wayne, Edwards, Wabash, White, Hamilton, Franklin, Jackson, Williamson, Saline, Gallatin, Hardin, Pope, Johnson, Union Alexander, Pulaski, or Massac. Nearby cities include: Vandalia, Fairview Heights, Belleville, O'Fallon, Centralia, East St Louis, Carbondale.

Additional Details:
• Department: YouthCare Care Management
• Schedule: M-F, 8-4:30 or 5 pm CT. 
• Caseload: DCFS Youth-In-Care and Former Youth-In-Care (ages 0-21) / Foster Care.****

Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substance use disorder.

  • Evaluates the needs of the member via phone or in-home visits related to the resources available, and recommends and/or facilitates the care plan/service plan for the best outcome, which may include behavioral health and social determinant needs
  • May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources
  • Develops ongoing care plans for members with high level acuity and works to identify providers, specialists, and community resources needed for care including mental health and substance use disorders
  • Coordinates as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members
  • Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs
  • Facilitates care coordination and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services
  • Collects, documents, and maintains member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
  • Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs
  • Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
  • Performs other duties as assigned.
  • Complies with all policies and standards.

    • Education/Experience: Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2 – 4 years of related experience.

    License/Certification:

  • Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience required
  • For Illinois Youth Care plan only: Graduate degree and independently licensed behavioral health clinician (e.g. LCSW, LCPC, PsyD) in Illinois or Bachelor’s Degree and IL RN licensure. Must reside in IL required
    • Pay Range: $55,100.00 - $99,000.00 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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