Behavioral Health Service Mgr

Company: Centene
Location: Midland
Posted on: January 17, 2020

Job Description:

Behavioral Health Service Mgr - Sign On Bonus Position Purpose: Perform duties related to the day-to-day operations of the Service Management functions for STAR KIDS members to achieve the highest possible levels of functioning and wellness by ensuring consistent, timely access to medically necessary behavioral health services. Monitor quality of care, assist with discharge planning. - Work with STAR KIDS Members, Medical Consenters, and providers to meet the behavioral healthcare needs of each member's condition. - Identify members who may benefit from service management, conduct an assessment and develop, implement and monitor a healthcare service plan. - Provide information to staff to facilitate development of the healthcare service case 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. - Travel is required. Education/Experience: Master's degree in Behavioral Health. 3+ years of case and/or utilization management experience. Experience in psychiatric health care settings, child behavioral health conditions and members with special needs. Working knowledge of utilization review procedures, and familiarity with mental health community resources. Thorough knowledge of a specialized or technical field such as clinical nursing, case and/or utilization management involving knowledge plus the application of basic theory. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff. License/Certification: Unrestricted license as a LCSW, LMFT, LMHC, LPC, PhD, PsyD or RN. For Superior Health Only: THIS POSITION IS A STAR KIDS - MED - CASE MANAGEMENT (STAFF MEMBER POSITION) Education/Experience: Previous experience with child behavioral health conditions or members with special needs. Previous experience acting as a lead in a functional area, managing cross functional teams on a large scale project, or supervisory experience including hiring, training, assigning work and managing the performance of staff, preferred but not required. Experience working in behavioral health managed care and clinical settings is preferred. NOTE: This is a FIELD-BASED/REMOTE POSITION and candidate must reside in MIDLAND OR ODESSA,TX. Candidates will need to travel and train up to 3 weeks at any Superior Health Plan location. 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. Medical Management USA-Texas USA-Texas-Midland, USA-Texas-Odessa, USA-Texas-Lubbock Superior HealthPlan Full-time

Keywords: Centene, Midland , Behavioral Health Service Mgr, Healthcare , Midland, Texas