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Care Manager - Chicago Illinois
Company: Meridian Illinois Location: Chicago, Illinois
Posted On: 01/19/2025
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. This position is a Hybrid position with a 25% travel in Cook County! Centene is hiring a Care Manager for our Illinois Health Plan for our Youth care program. The ideal candidate will have a Behavioral Health clinical License, knowledge of care coordination and foster care, DCF. Must reside in one of the following zip codes: 60601,60602, 60603, 60604, 60605, 60606, 60607, 60608, 606010, 60611, 60612, 60613, 60614, 60618, 60622, 60624,60625, 60626, 60631, 60634, 60639, 60640, 60641, 60642, 60644, 60645, 60646, 60647, 60651, 60654, 60656, 60657, 60659, 60660, 60661, 60666, 60668, 60670, 60673, 60674, 60675, 60677, 60678, 60680, 60681, 60682, 60684, 60685, 60687, 60688, 60690, 60691, 60693, 60694, 60699, 60701 Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substance use disorder. - Evaluates the needs of the member via phone or in-home visits related to the resources available, and recommends and/or facilitates the care plan/service plan for the best outcome, which may include behavioral health and social determinant needs
- May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources
- Develops ongoing care plans for members with high level acuity and works to identify providers, specialists, and community resources needed for care including mental health and substance use disorders
- Coordinates as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members
- Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs
- Facilitates care coordination and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services
- Collects, documents, and maintains member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
- Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs
- Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
- Performs other duties as assigned
- Complies with all policies and standards
Education/Experience: Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2 - 4 years of related experience. License/Certification: |
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