Supervisor, Care Management
Company: Centene Corporation
Posted on: February 6, 2024
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
Must live in OklahomaOklahoma Complete Health, a Centene company,
is committed to providing quality healthcare solutions to transform
the health of Oklahomans.
At Oklahoma Complete Health, we are community advocates and
change-makers in search of an inclusive culture grounded by our
commitment to work-life balance, competitive compensation, and
continuous career development. Join us and be a part of a
collaborative, growing network of innovative thinkers delivering
solutions at the local level.Position Purpose: Under the direction
of the Director of Care Management, the Supervisor of Care
Management is responsible for implementing the Care Management
programs in multiple environments including Prior Authorization,
Concurrent Review and Care Management. Manages the daily
operational processes to assure the continuum of care that
addresses the ongoing needs of the members served by the care
management process. A patient advocacy approach with a seamless
integration of services is required and must be balanced within the
member's benefit structure. Emphasis will be placed on continuity
of care, assisting members in obtaining access to care, and member
- Directs personnel supervision of associates to include hiring,
training and performance evaluations.
- Assures appropriate triage of members at risk.
- Supervises the assessment of members' situations and
functioning, assuring identification of individual needs.
- Assures assessment information is used to develop a
comprehensive care management plan to address the members'
- Manages the planning process to assure the specific objectives,
goals and actions are designed to meet the members' needs as
identified throughout the planning process.
- Responsible for implementing and coordinating activities that
will lead to the accomplishment of goals set forth in the care
- Performs resource management, and organizes, secures,
integrates and modifies resources to meet the goals.
- Assures processes are in place to identify deficits between
benefits and member requirements, and utilizes community and
ancillary services to assure continuity of care for the
- Performs the direct supervision of care managers, assures the
proactive identification of members at risk and in need of care
management services, and identifies educational opportunities.
- Assesses caseloads and realigns assignments to meet
- Works in collaboration with Medical Informatics and the Quality
Improvement departments and monitors programs to meet the needs of
our membership and those in the Care Management process.
- Monitors information from all relevant sources about the care
management plan and activities to determine the plan's
- Performs the daily activities necessary to evaluate the
effectiveness of the care management plan at appropriate intervals,
and determines if outcomes were successful and goals were met.
- Works in collaboration with the Care Management Directors in
each state to identify areas of opportunity and/or provider
- Maintains Care Management vendor relationships on a daily and
aggregate basis to assure the care given to our members is
appropriate and compliant with PHS policies and governmental
- Communicates with providers, members and community resources as
necessary to support the planning, implementation and evaluation of
the patient's plan of care.
- Performs audit activities as required, and participates in
establishment of corrective action as necessary.
- Assures the use of appropriate criteria when making
- Performs Care Management activities as
required.Education/Experience: CCM, Baccalaureate degree preferred;
MSW with appropriate care management experience may be considered.
Five years of clinical experience and at least two years of
supervisory experience, preferably with HMO experience in a medical
License/Certification: Current, valid and unrestricted professional
licensure is required; Current, valid and unrestricted RN
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: Centene Corporation, Lawton , Supervisor, Care Management, Executive , Lawton, Oklahoma
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