Manager, Case Management
Company: Centene Corporation
Location: Oklahoma City
Posted on: September 18, 2023
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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.Oklahoma Complete Health, a Centene company,
is committed to providing quality healthcare solutions to transform
the health of Oklahomans.
At Oklahoma Complete Health, we are community advocates and
change-makers in search of an inclusive culture grounded by our
commitment to work-life balance, competitive compensation, and
continuous career development. Join us and be a part of a
collaborative, growing network of innovative thinkers delivering
solutions at the local level.
Position Purpose: Perform duties to conduct and manage the day to
day operations of the care management functions communicating with
departmental and plan administrative staff to facilitate daily
department functions.--- Manage the delivery of services to
members, ensuring services are appropriate and cost effective.
--- Ensure compliance with government and company requirements in
the care management department. Develop and implement new
procedures, regulatory filings and manage compliance issues.
--- Develop, implement, and oversee care management policies and
procedures and give specific guidance to staff and departments as
appropriate.
--- Develop, implement, and maintain care management programs to
facilitate the use of appropriate services and resources in order
to maintain the member in the least restrictive environment.
--- Direct the daily activities of care management staff.
Facilitate on-going communication between case management staff,
members, contracted providers, and subsidiaries.
--- Develop staff skills and competencies through training and
experience.
--- Manage resolution of complaints, and assist in audits and
evaluations related to the Long Term Care Program. If necessary,
develop and implement corrective action plans.** Must reside in
Oklahoma**Education/Experience: Bachelor's degree in Social Work,
Sociology, Psychology, Nursing, Gerontology, related field or RN.
6+ of long term care related experience. Thorough knowledge of case
and/or utilization management. Familiarity with Medicaid managed
care practices and policies, CHIP, and SCHIP. 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.For
Oklahoma Complete Health only: -Education: Bachelor's degree in
nursing preferred. -License/Certification: Active, OK Registered
Nurse (RN) -license required, CCM preferred.Children's Specialty
Program - Knowledge in Oklahoma Child Welfare systems, Behavioral
Health, trauma, resources for caregivers, foster parents, HEDIS and
quality measures. -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: Centene Corporation, Oklahoma City , Manager, Case Management, Executive , Oklahoma City, Oklahoma
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