Position Purpose: Develops, assess and coordinates holistic care management activities, with primary focus and support towards populations with significant mental/behavioral health needs, to enable quality, cost-effective healthcare outcomes. Evaluates member service needs and develops or contributes to development of care plans/service plans, and educates members, their families and caregivers on services and benefits available to meet member needs.

Key Details: This is a Hybrid position - In Person Member Engagement via home visits and work from home. An unrestricted behavioral health professional license based on state contract requirements (e.g., LCSW, LMFT, LMHC, or LPC) is required for the applicable state upon application submission. Work Schedule: Monday - Friday: 8:00 am - 5:00 pm (CST), NO On Call, Evenings, Weekends or Holidays

Service Delivery Area: Pearland, TX and the surrounding counties; Mileage reimbursement is provided for member assessment visits.

• Evaluates the needs of the most complex and high-risk members with mental/behavioral health needs, and recommends a plan of care for the best outcome
• Acts as liaison and member advocate between the member/family, physician, and facilities/agencies
• Supports members with primarily mental/behavioral health needs, such as those with (or a history of) major depression, bipolar disorders, schizophrenia, borderline personality disorder, post-traumatic stress disorder, substance use disorder, self-injurious behavior, psychiatric inpatient admissions, etc
• Performs frequent home and/or other site visits (up to 75% monthly travel for home visits) to assess member needs and collaborate with resources, as required
• Provides and/or facilitates education to long-term care members and their families/caregivers on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, and healthcare benefits. Provides subject matter expertise and operational support for relevant mental and behavioral health-focused activities, such as the handling of crisis calls, mental health first aid training, field safety and de-escalation practices, psychotropic and other medication monitoring, etc
• Educates on and coordinates community resources, to include medical, behavioral and social services. Provides coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living)
• Ensures appropriate referrals based on individual member needs and supports the identification of providers, specialists, and community resources. Ensures identified services are accessible to members
• Maintains accurate documentation and supports the integrity of care management activities in the electronic care management system. Works to ensure compliance with clinical guidelines as well as current state and federal guidelines
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Comply with all policies and standards

Education/Experience: Requires a master’s degree in Mental Health Counseling or Social Work and 2 – 4 years of related experience.

License/Certification:

• An unrestricted behavioral health professional license based on state contract requirements (e.g., LCSW, LMFT, LMHC, or LPC) is required and must be license in the applicable state

Preferred Experience:

• 4+ years of case management experience, preferably within child welfare systems, adoption, foster care, Child Protective Services, pediatric acute care settings or in-patient treatment facilities, schools, or local or state MHA/BHAs for youth
• Experience collaborating with medical and behavioral health providers and managing community resources for Foster Care Medicaid recipients.
• Experience managing high volume caseloads
• Field-based experience strongly preferred
• Strong clinical documentation, problem-solving, communication, attention to detail, organizational, and time management skills required.
• Ability to adapt to changing business needs with openness, flexibility, and professionalism.
• Proficient technology skills and direct experience working within web-based applications and case management systems (i.e. TruCare, Microsoft Office Site – Outlook, M365 Copilot, Excel, PowerPoint, Word, OneNote, etc).
• Must be able to work independently with minimal supervision.
• Experience working in managed care environment is a PLUS (Federal and State Sponsored Govt Programs)
• Bilingual English/Spanish skills are a plus but not required.

NOTE: For Superior Health Plan: Department of Family & Protective Services (DFPS) background check is required.

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
 

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-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act