Care Manager

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.

Centene's IL Health Plan is looking for a licensed Behavioral Health Clinician or Bachelor's degreed RN with Behavioral Health experience to support the YouthCare program.

This position is telephonic care management, remote/work from home with 10% travel to participate in quarterly team meetings. Applicants must reside in the state of IL in one of the following counties:
- Madison, Bond, Fayette, Effingham, Jasper, Crawford, Monroe, St. Clair, Clinton, Marion, Clay, Richland, Lawrence, Washington, Jefferson, Wayne, Edwards, Wabash, Randolph, Perry, Franklin, Hamilton, White, Jackson, Williamson, Saline, Gallatin, Union, Johnson, Pope, Hardin, Alexander, Pulaski, Massac.

Ideal applicants will have knowledge of the Child Welfare System or DCFS which is very helpful.

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:
- 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: $56,200.00 - $101,000.00 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-