Behavioral Health Clinical Care Mgr
Company: Envolve People Care
Posted on: January 15, 2022
You could be the one who changes everything for our 25 million
members. Centene is transforming the health of our communities, one
person at a time. As a diversified, multi-national organization,
you'll have access to competitive benefits including a fresh
perspective on workplace flexibility.
Position Purpose:Handle inbound and outbound member and provider
calls on a clinical phone queue. Ensure members receive behavioral
health services appropriate to clinical need. Triage crisis calls
to assist with stabilization and access to emergency evaluation.
Coordinate services with other departments, such as medical
case/care management. Perform utilization management functions,
including authorization determinations and care shaping.
Handle member calls, performing activities such as telephonic
clinical assessment, determining appropriate level of care and
services and answering benefit questions.
Perform utilization review functions with behavioral health
providers, including care shaping and authorization
Responsible for utilization management activities with providers
and/or member calls, depending on team.
Triage crisis calls, providing in-the-moment support and assisting
with access to emergency services.
Use established protocols, as well as clinical judgment, to
evaluate and problem solve during interactions with members and
Document all calls and activities within a data management system
and access multiple databases for benefit and workflow
Enhance clinical knowledge and skills by actively participating in
all assigned training and staff meetings
Education/Experience:Master's degree in behavioral health and 3+
years of behavioral health experience (at least 2 years must be
post-Master's degree). Prior managed care experience preferred.
Prior experience with multiple system applications and electronic
data entry, including call center and/or health care databases
License/Certification:Unrestricted license as Licensed Clinical
Social Worker (LCSW), Licensed Professional Counselor (LPC),
Licensed Professional Clinical Counselor (LPCC), Licensed Marriage
and Family Therapist (LMFT) or Licensed Psychologist (PhD).
Our Comprehensive Benefits Package:
Flexible work solutions including remote options, hybrid work
schedules and dress flexibility
Paid Time Off including paid holidays
Health insurance coverage for you and dependents
401(k) and stock purchase plans
Tuition reimbursement and best-in-class training and
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.
Keywords: Envolve People Care, Cypress , Behavioral Health Clinical Care Mgr, Healthcare , Cypress, California
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