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 workplace flexibility.THIS POSITION IS REMOTE/WORK FROM HOME. QUALIFIED APPLICANTS MUST RESIDE IN ONE OF THE FOLLOWING IL COUNTIES: CHAMPAIGN, CLARK, COLES, CUMBERLAND, DEWITT, DOUGLAS, EDGAR, MACON, MOULTRIE, PIATT, SHELBY OR VERMILION.THIS ROLE WILL TRAVEL 25% OF THE TIME TO VISIT MEMBERS ON THE HOME & COMMUNITY BASED WAIVER PROGRAM. AVERAGE CASE LOAD 60 - 70 MEMBERS - 4-6 ON WAIVERS REQUIRING A HOME VISIT 1 X 90 DAYS.Position Purpose: Perform duties related to the day to day operations of the Integrated Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life for both behavioral and physical health issues. Assess members' current functional level and, in collaboration with the member, develop and monitor the Case Management Care Plan, monitor quality of care; assisting with discharge planning, participating in special clinical projects and communicate with departmental and plan administrative staff to facilitate daily operations of the Integrated Case Management functions. Collaborate with both medical and behavioral providers to ensure optimal care for members.· Work telephonically with patients identified as high risk, for both behavioral and physical health issues, and their providers to identify needs, set goals and implement action steps towards achieving goals.· Empower patients to help them improve their quality of life and ensure an integrated approach to address complex issues.· Understand and comply with NCQA guidelines and HEDIS measures.· Comply with established referral, pre-certification and authorization policies, procedures and processes by related Medical Management staff.· Other duties as assigned· Performs other duties as assigned· Complies with all policies and standards· Travel 25% to visit members in their homes (average 4-6 members on Home & Community Based waivers 1 x 90 days).Education/Experience: Master’s degree in behavioral health and an unrestricted license as a LCSW, LMFT or LPC, or a PhD, PsyD or RN. 3+ years of case and/or utilization management experience. Experience in psychiatric and medical health care settings. Working knowledge of mental health community resources.License/Certification: Unrestricted license as a LCSW, LMHC, LMSW LMFT, LPC, PhD, PsyD or RN license in applicable state.For Illinois YouthCare plan only: Candidates are required to live within the specified region. Valid driver's license and auto insurance required.Pay Range: $25.97 - $46.68 per hourCentene 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. Total compensation may also include additional forms of incentives.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.
