Supervisor Case Management - (CF11464)

Centene Corporation provides multi-line managed care programs and related services to individuals receiving benefits in Medicaid, including Supplemental Security Income (SSI) and the State Children's Health Insurance (SCHIP). Centene operates health plans in seven states. In addition, the Centene contracts with other healthcare organizations to provide specialty services including behavioral health, disease management, nurse triage and treatment compliance.

Position Purpose:
To supervise the day-to-day operations of the case management functions communicating with departmental and plan administrative staff to facilitate daily department functions.

Knowledge/Experience:
Bachelor's degree in nursing, social work or equivalent, and 2 - 3 years case management, utilization management and recent experience providing services to persons who are elderly and/or persons with physical or developmental disabilities. Supervisory or lead experience preferred.

Competencies:
Manager: Integrity, Flexibility, Communication, Critical Thinking, Customer Focus, Decision Making, Planning and Organizing, Building Strategic Working Relationships, Technical and Professional Knowledge

Position Responsibilities:
o Oversee the workflow and day-to-day operations of the case management function including supervising staff.
o Assure compliance with established referral, pre-certification and authorization policies, procedures and processes by related Medical Services staff.
o Assure compliance with established onsite and concurrent review, case management, referral, pre-certification and authorization policies, procedures and processes.
o Assist with the implementation of policies and procedures regarding medical case management functions.
o Maintain compliance with federal and state regulations and contractual agreements.
o Coordinate and communicate medical services functions with other departmental functions at the business as assigned.
o Develop staff skills and competencies through training and experience. Coach and mentor.

o License/Certifications: RN (Registered Nurse) or LCSW (Licensed Certified Social Worker) preferred. Current state driver's license.


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