Behavioral Health Service Mgr - Foster Care
Company: Sunshine State Health Plan
Location: West Palm Beach
Posted on: November 18, 2023
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
Position Purpose: Perform duties related to the day-to-day
operations of the Service Management functions for Foster Care
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 Foster Care Members, Medical Consenters, Department
of Family and Protective Services (DFPS) staff and providers to
meet the behavioral healthcare needs of each foster care member's
- Identify foster care members who may benefit from service
management, conduct an assessment and develop, implement and
monitor a healthcare service plan.
- Provide information to DFPS staff to facilitate development of
the DFPS 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
- 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
- Maintain compliance with federal and state regulations and
- Coordinate service management functions with other departmental
- Monitor data to address trends or potential quality improvement
- Maintain HIPAA compliance.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.
Foster care experience strongly preferred.
License/Certification: Unrestricted license as a LCSW, LMFT, LMHC,
LPC, PhD, PsyD or RN.
For Sunflower Health Plan Only: Unrestricted license as a LMSW,
LCSW, LMFT, LMHC, LPC, PhD, PsyD or RN.
For Superior Health Only:
Education/Experience: No previous experience with Foster care,
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.
DFPS background check required
For North Carolina only: Behavioral Health (BH) Managers and
Full-Time BH Staff: These individuals shall be responsible for
integrating into the clinical and care management teams to ensure
Member's behavioral health needs are fully integrated into the
service delivery system.
- Must reside in North Carolina
- Experience working in behavioral health managed care and
- Licensed behavioral health professional practicing within their
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.
Keywords: Sunshine State Health Plan, Miami , Behavioral Health Service Mgr - Foster Care, Healthcare , West Palm Beach, Florida
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