Supervisor, LTSS Clinical Care Management

Job Opportunity At Centene

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. Qualified candidate must reside in the state of Delaware. This is a remote role with up to 40% field based work.

Position Purpose :

Supervises the care coordination team that serves long-term care members with physical / medical health needs and / or behavioral / mental health needs to promote quality and efficacy of care management delivery. Supervises day-to-day escalations and care management issues related to members or providers. Monitors and reviews long-term care management required documentation to maintain and ensure compliance with federal and state regulations and contractual agreements. Assigns caseloads and work assignments to long-term care management team based on state requirements, care management staff experience, and member needs. Works with long-term care senior management on escalated and complex care cases related to physical and / or behavioral health, and provides guidance to junior team members to address member concerns. Educates and provides resources for long-term care management team on key initiatives and member outreach to facilitate on-going communication between care management team, members, and providers. Evaluates long-term care management team performance and provides feedback regarding performance, goals, and career milestones. Provides coaching and guidance to long-term care management team and providers to ensure members are receiving high quality care and information regarding service / care plan options, procedures, referrals, and healthcare benefits. Monitors and review reports on a regular basis ensuring quality and productivity metrics are met and for case assignments, and may perform audits of staff on a regular basis. May perform telephonic, digital, home and / or other site outreach to assess member needs and collaborate with resources. Assists with onboarding, hiring, and training long-term care management team members. Leads and champions change within scope of responsibility. Performs other duties as assigned. Complies with all policies and standards.

Education / Experience :

Positions overseeing RN team members : Requires Graduate from an Accredited School of Nursing or a Bachelor's degree and 4+ years of related experience Or, Positions overseeing BH team members : Requires a Master's degree or Graduate from an Accredited School of Nursing and 4+ years of related experience. Highly advanced clinical knowledge and ability to assess member needs in context of relevant diagnoses, treatment plans and goals, and identify potential gaps in care or risks for readmission or complications preferred. Strong knowledge of healthcare managed care principles preferred. Experience working with providers and healthcare teams to develop appropriate long-term care plans / service plans preferred. Strong knowledge of medication indications and side effects and / or knowledge of BH care management principles preferred.

License / Certification :

Positions overseeing RN team members : Current state's Registered Nurse (RN) license Upon Hire required or Positions overseeing BH team members : Licensed Clinical Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, and RN with BH experience required Upon Hire required.

Pay Range : $85,300.00 - $158,100.00 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-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.