Manager, Care Management
Company: Oklahoma Complete Health
Posted on: November 18, 2023
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
Position Purpose: Perform duties to conduct and manage the day to
day operations of the care management functions communicating with
departmental and plan administrative staff to facilitate daily
Manage the delivery of services to members, ensuring services are
appropriate and cost effective.
Ensure compliance with government and company requirements in the
care management department. Develop and implement new procedures,
regulatory filings and manage compliance issues.
Develop, implement, and oversee care management policies and
procedures and give specific guidance to staff and departments as
Develop, implement, and maintain care management programs to
facilitate the use of appropriate services and resources in order
to maintain the member in the least restrictive environment.
Direct the daily activities of care management staff. Facilitate
on-going communication between case management staff, members,
contracted providers, and subsidiaries.
Develop staff skills and competencies through training and
Manage resolution of complaints, and assist in audits and
evaluations related to the Long Term Care Program. If necessary,
develop and implement corrective action plans.
Education/Experience: Bachelor's degree in Social Work, Sociology,
Psychology, Nursing, Gerontology, related field or LPN/RN. 6+ of
long term care related experience. Thorough knowledge of case
and/or utilization management. Familiarity with Medicaid managed
care practices and policies, CHIP, and SCHIP. Previous experience
as a lead in a functional area, managing cross functional teams on
large scale projects or supervisory experience including hiring,
training, assigning work and managing the performance of staff.
License/Certification: Valid driver's license.
For New Hampshire Healthy Families: Active driver's license in good
For North Carolina plan: LCSW, RN, LPC, LMFT, or Psychologist in
Must reside in North Carolina
If serving members with BH conditions, must: o Be a master's-level
fully Licensed Clinical Social Worker (LCSW), fully Licensed
Clinical Mental Health Counselor (LCMHC), fully Licensed
Psychological Associate (LPA), fully Licensed Marriage and Family
Therapist (LMFT) or licensure as a Registered Nurse (RN)
Have three (3) years of experience providing care management, case
management, or care coordination to the population being served
For Coordinated Care - Washington - Must have and maintain current,
valid and unrestricted professional license (i.e. Licensed Mental
Health Counselor (LMHC), Licensed Clinical Social Worker (LCSW),
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.
Keywords: Oklahoma Complete Health, Lawton , Manager, Care Management, Executive , Lawton, Oklahoma
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