Centene Corporation Care Manager, Health & Recovery Plan in Rego Park, New York
ProfessionalPosition Purpose: Perform work associated with promoting and restoring the health of Health and Recovery Plan (HARP) members by identifying member care requirements, documenting, and ensuring maximal access to high quality care across the continuum. Collaborate with Member, Health Homes, physicians, other interdisciplinary team members, and family members and/or supportive others to support and sustain the Member’s wellness and recovery goals. Follows best practice and clinical standards, and adheres to departmental and State guidelines.
Mental Health/Chemical Dependency: Utilize expertise of best practice standards to render medical and social necessity determinations.
Quality of Care: Adhere to clinical standards of care through collaboration with providers in order to ensure appropriate outcomes.
Case Management: Communicate with members, family and other medical personnel as necessary to facilitate a desired outcome.
Pharmacology: In collaboration with Physician Advisor, assess appropriateness and effectiveness of medications in order to determine a medications use, dosage, side effect as applied to different disease states.
Electronic Records: Manage electronic files to create patient files in order to document patient records, treatments, and progress.
Regulatory Guidelines: Practice and adhere to departmental and state guidelines in order to protect self, members, and organization.
Professional Development: Attend educational workshops; review professional publications; establish personal networks; participate in professional societies in order to maintain professional and technical knowledge.
Other duties as required: Performs other tasks in order to contribute to the team effort.
Education/Experience: MA/MS Masters Degree or equivalent required. One to three years clinical and managed health care experience required. Three to five years experience working with Behavioral Health and/or Substance Use required.
License/Certification: NYS LMSW, LCSW, LMHC, or RN, License required
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.
TITLE: Care Manager, Health & Recovery Plan
LOCATION: Rego Park, New York
COMPANY: Clinical & Nursing
POSITION TYPE: Professional