Behavioral Health Program Manager at Sunshine State Health Plan
Hialeah, FL
About the Job
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.
- Project leads behavioral health and/or behavioral health home program development and integration activities both internally and externally.
- Improves quality of behavioral health product by driving cross functional initiatives.
- Utilizes data to identify and manage change necessary to achieve performance improvement.
- Communicates and educates associates on behavioral health strategy.
- Develops behavioral health clinical educational materials, and performs provider behavioral health education.
- Works to develop and enhance relationships within the provider community, including behavioral health homes, community mental health centers, hospitals and individual providers (BH Providers and PCP's) and groups identified that are participating in Physical/ Behavioral integration activities.
- Designs, develops and implements behavioral health related clinical training for associates and providers.
- Works with utilization, case and disease management teams to implement and operationalize BH/PH integration initiatives.
- Educates health plan leadership and cross functional staff on behavioral health and integration strategy ensuring all entities understand and support the initiatives.
- Produces professional presentations and training materials to be utilized for training of providers and associates.
- Manages behavioral health specific policy and procedure development, clinical program descriptions, and other related documentation requirements.
- Assists with behavioral health provider and/or home provider audits as needed.
- Assists with analysis of behavioral health utilization data, KPI review and monitoring of behavioral health utilization management metrics. Participates with development of corrective action plans and associated activities for areas that need improvement.
- Performs duties and responsibilities as assignedAdditional Responsibilities: * Assist behavioral health home candidates to prepare their organization for becoming Patient-Centered Specialty Practice (PCSP) recognized through NCQA.
- Oversees compliance with behavioral health home contracts and standards.
Candidate Experience: Required 5+ years of experience in behavioral health, preferably in public sector
Preferred Other Managed care experience Licenses and Certifications: A license in one of the following is required: Required Licensed Clinical Mental Health Counselor (LCMHC)
Required Licensed Clinical Marriage & Family Therapist (LCMFT): Required Licensed Clinical Social Worker (LCSW)
Preferred A Master's Degree in counseling, social work, psychology, or related human service field
Pay Range: $67,400.00 - $121,300.00 per yearCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act