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Job description
Position Purpose:
nServe as a liaison for external groups and providers regarding clinical information from the Operations and Medical Management teams. Assesses and performs review of member clinical records and services related to behavioral health and substance use.
nKey Details: This is a remote position. Hours will align with Pacific or Mountain Time (PST/MST). Outpatient experience strongly preferred.
nnnInterpret and present program results and develop data-driven analysis and metrics used to measure effectiveness and ROI of all current and new programs
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nnPartner with various staff, along with internal and external departments on provider education and outreach; determine where there are gaps and work to develop and deploy education efforts
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nnPartner with regional leadership for providers requiring a clinical interpretation of results related to health plan reporting, data and quality incentive payments; facilitate discussions to make recommendations
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nnImplement and manage procedures for tracking, identifying and problem-solving operational issues, including issues between the provider network, community, and the facility, and make recommendations to solve
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nnAct as the clinical representative in various meetings
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nnCollaborate with staff to identify internal and external opportunities and initiate process changes to increase quality and improve staff, provider and member satisfaction
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nnServe as resource and liaison on utilization, quality improvement and case management activities
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nnPerforms other duties as assigned.
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nnComplies with all policies and standards.
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n nEducation/Experience:
nMaster's Degree In Social Work or Behavioral Health required
n4+ years experience providing behavioral health outpatient care in a community setting or independent practice required
nExperience with assessment of treatment plans related to mental health and substance abuse across the continuum of care required
nExperience with managed care, case management, utilization management, or quality improvement required
nLicenses/Certifications:
nLCSW - Licensed Clinical Social Worker required or
nLMHC - Licensed Mental Health Counselor required or
nLPC - Licensed Professional Counselor required or
nLMFT - Licensed Marital and Family Therapist required or
nLMHP - Licensed Mental Health Professional required or
nLicensed Clinical Psychologist required or:
n*State specific licensure may be required for the following states: AZ, FL, GA, NV, SC, NC, and WA required
nPay Range: $70,100.00 - $126,200.00 per year
nAt Centene, we connect people to the care they need to live healthier lives - and the work you do here makes that impact real every day. You'll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It's work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
nCentene 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
nCentene 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.
nQualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Worksite address
salem, OR, 97308, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.