Behavioral Health Service Mgr - Foster Care

Company: Sunshine State Health Plan
Location: West Palm Beach
Posted on: November 18, 2023

Job Description:

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 workplace flexibility.
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 condition.
• 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 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.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 clinical setting
  • Licensed behavioral health professional practicing within their scope
    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