Posted on: December 5, 2019
Supervisor, Clinical Position Purpose: Supervise and facilitate the
daily operations of the case management and utilization management
functions - Oversee the workflow and day-to-day operations of high
risk case management and utilization management functions,
including implementation of policies and procedures - Ensure
compliance with established initial and concurrent review, case
management, referral, pre-certification and authorization policies,
procedures and processes - Act as a liaison with other business
units and facilitate on-going communications between case
management and utilization management staff, community agencies and
contracted providers - Provide oversight of telephonic review of
inpatient admissions with doctors, hospitals, and other providers -
Monitor the effectiveness for existing outreach efforts and ensure
appropriate knowledge/education and interventions are conducted for
members defined to be at risk - Analyze data to address trends or
potential quality improvement opportunities including provider
issues, service gaps and member needs Education/Experience: RN
license or Master's degree in Behavioral Health or related field.
3+ years of case and/or utilization management experience.
Experience in a psychiatric health care setting, including
familiarity with mental health community resources. Working
knowledge of a specialized or technical field, such as clinical
nursing, case and/or utilization management. Previous experience as
a lead in a functional area or managing cross functional teams on
large scale projects. License/Certification: Current state's
unrestricted license as a LCSW, LMFT, LMHC, LPC, PhD, PsyD or RN.
Candidates with Child Welfare or the Foster Care System highly
preferred.. 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.
Clinical & Nursing USA-Florida-Jacksonville USA-Florida-Maitland,
USA-Florida-Pensacola, USA-Florida-Tampa, USA-Florida-Sunrise
Sunshine State Health Plan Full-time
Keywords: Centene, Jacksonville , Supervisor, Clinical, Healthcare , Jacksonville, Florida
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