Care Manager II (Social Work)

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Job title: Care Manager II (Social Work)

Company: Centene

Job description: 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.

Must live in Oklahoma

Oklahoma 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: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.

• Assess the member’s current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
• Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member’s needs and promote desired outcomes
• Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
• Provide patient and provider education
• Facilitate member access to community based services
• Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
• Actively participate in integrated team care management rounds
• Identify related risk management quality concerns and report these scenarios to the appropriate resources.
• Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
• Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
• Direct care to participating network providers
• Perform duties independently, demonstrating advanced understanding of complex care management principles.
• Participate in case management committees and work on special projects related to case management as needed.
• For Michigan Complete Health – home visits required.
• May assist with mentoring, training and coaching of staff on team.
• May be responsible for assignment of work/distribution among the team.

Education/Experience: Bachelor’s degree in Social Work. 2+ years of social work experience in an acute care or community setting and 1+ years of case management experience in a managed care setting. Experience government sponsored managed care programs.

Licenses/Certifications: Current state’s LMSW or LCSW license.

For Oklahoma Complete Health Plan Only: a Bachelor’s degree in social work, psychology, or a related social services field; OR licensed clinical social worker with a license to practice in the State of Oklahoma. Must successfully complete the Behavioral Health Case Manager certification training provided through the Department of Mental Health and Substance Abuse Services within (6) months of date of hire.

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.

Expected salary:

Location: Shawnee, OK

Job date: Sun, 19 Nov 2023 08:26:56 GMT

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