You could be the one who changes everything for our 26 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.

• Work with Members, Medical Consenters, clinical staff and providers to meet the behavioral healthcare needs of each pediatric member’s condition.
• Identify members who may benefit from service management, conduct an assessment and develop, implement and monitor a behavioral healthcare service plan.
• Provide information to clinical staff to facilitate development of the behavioral healthcare service plan
• Update database regularly with most recent Service Management Plan of Care.
• Review information submitted by providers into the database to ensure material is appropriate and consistent with guidelines for data inclusion.
• Encourage behavioral health providers to use evidence-based practices and confirm that behavioral health providers and PCP’s are sharing information as required.
• Comply with established referral, pre-certification and authorization policies, procedures and processes by related medical management staff.
• Maintain compliance with federal and state regulations and contractual agreements.
• Coordinate service management functions with other departmental functions.
• Monitor data to address trends or potential quality improvement opportunities.
• Maintain HIPAA compliance and travel is required to conduct IN-PERSON member assessments.

Education/Experience:

• Master's degree in relevant field (e.g. social work, clinical mental health counseling, psychology) OR Associates/Bachelor’s degree in Nursing specializing in psychiatric/mental health.

• 3+ years of direct behavioral health/psychiatric experience, case management, utilization management, or service coordination

Preferred Experience:

• Experience working in psychiatric health care settings, In-patient and Outpatient, treatment facilities, or state mental health community agencies - Local Mental Health Authorities OR

• Experience working with child behavioral health conditions and members with special needs OR

• Experience working in a FIELD-Based Behavioral Health role

• Working knowledge of utilization review procedures, and familiarity with mental health community resources.

License/Certification: Required unrestricted license as a LCSW, LMFT, LPC, or RN in the applicable and driver’s license is required.

HYBRID/REMOTE - Work from home AND travel to conduct behavioral health assessments IN-PERSON with children and adolescent members.

Monday - Friday: 8 am - 5 pm, NO weekends, NO evenings, NO On-Call

Competitive Pay, Regular Employee Full-time Benefits, Sign On Bonus and Mileage reimbursement is granted for travel requirements.

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.