Job type full-time
Full job description
Headquartered in tampa, fla., wellcare health plans, inc(nyse: wcg) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through medicaid, medicare advantage and medicare prescription drug plans, as well as individuals in the health insurance marketplaceWellcare serves approximately 5.5 million members nationwide as of september 30, 2018Wellcare is a fortune 500 company that employs nearly 12,000 associates across the country and was ranked a `world`s most admired company` in 2018 by fortune magazineFor more information about wellcare, please visit the company`s website at www.wellcare.comEoe: all qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification appliesComprehensive health management, incIs an equal opportunity employer, m/f/d/v/so.
You could be the one who changes everything for our 25 million membersCentene is transforming the health of our communities, one person at a timeAs a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Perform duties related to the day to day operations of the integrated case management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life for both behavioral and physical health issuesAssess members’ current functional level and, in collaboration with the member, develop and monitor the case management care plan, monitor quality of care; assisting with discharge planning, participating in special clinical projects and communicate with departmental and plan administrative staff to facilitate daily operations of the integrated case management functionsCollaborate with both medical and behavioral providers to ensure optimal care for members.
Work telephonically with patients identified as high risk, for both behavioral and physical health issues, and their providers to identify needs, set goals and implement action steps towards achieving goalsEmpower patients to help them improve their quality of life and ensure an integrated approach to address complex issues.
Understand and comply with ncqa guidelines and hedis measures.
Comply with established referral, pre-certification and authorization policies, procedures and processes by related medical management staff.
Master’s degree in behavioral health and an unrestricted license as a lcsw, lmft or lpc, or a phd, psyd3+ years of case and/or utilization management experienceExperience in psychiatric and medical health care settingsWorking knowledge of mental health community resources.
Unrestricted license as a lcsw, lmhc, lmsw lmft, lpc, phd, psyd or license in applicable state.
Our comprehensive benefits package:
Flexible work solutions including remote options, hybrid work schedules and dress flexibility
Paid time off including paid holidays
Health insurance coverage for you and dependents
401(k) and stock purchase plans
Tuition reimbursement and best-in-class training and development
All your information will be kept confidential according to eeo guidelines.