5877 licensed clinical social worker jobs found

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform duties to conduct and manage the day to day operations of the utilization management function. Communicate with staff to facilitate daily department functions. • Review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives. • Promote compliance with federal and state regulations and contractual agreements. • Develop, implement and maintain compliance, policies and procedures regarding medical utilization management functions. • Develop, implement, and maintain utilization management programs to facilitate the use of appropriate medical resources and decrease the business unit's financial exposure. • Compile and...

Job Description This manager-level position is responsible for a segment within a given practice focused on a specific industry, product/service line or specialty area. Responsible for managing the three main pillars of a practice: people management, portfolio/delivery management and sales enablement. Has profit and loss responsibility or financial/expense management of practice. This position is responsible for managing multiple teams in providing quality analysis, studies, product innovations on external customer engagement to achieve operational and functional targets with significant contribution towards the achievement of immediate and short-term results for the team, department and Oracle. Understands business metrics/key performance indicators required for team to deliver the results. Establish and communicate team or department goals that support and advance team, department and organization objectives; establish metrics or other performance measures to track...

Job Description As a Behavioral Health Clinical Consultant for the Cerner Federal Team, you will be responsible for partnering with Cerner client stakeholders to form relationships and driving successful clinical engagements through the application of Cerner's methodology. You will lead client meetings and facilitate discussions around adoption of technology and use industry information and data analytics, including trends and best practices, and other information, to produce internal and external communiques and recommendations. You will support value realization using a holistic approach to impact client performance, satisfaction, and business outcomes during project engagements positioning clients to be recognized within the industry and gaining alignment as a strategic partner. You will provide clinical guidance and expertise to the internal project team. You will consult and cross collaborate with internal and external clients understand workflows and facilitate the...

Summary The Behavioral Health Therapist provides behavioral health support and psychotherapy for patients and families within a pediatric primary care setting. The Behavioral Health Therapist uses various therapeutic interventions including individual and family therapy, supportive counseling, and crisis intervention. This role provides psycho-education to adolescents and/or caregivers of patients coping with acute and chronic medical and mental health conditions. Ongoing supportive counseling is provided for patient/families to promote wellness and maintain functional behaviors. The Behavioral Health Therapist works within a multidisciplinary team and collaborates with the patient’s primary care physician and treatment team to advance the medical plan of care. The therapist may also collaborate with various agencies to support the family’s effort in caring for their child. Hours : 8am-5pm M-F *Multiple Positions Available* Required Education, Licensure &...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. This position supports our Higher Level of Care Team and the work hours are 9a-6p or 9:30a -6p pacific time. Position Purpose: Handle inbound and outbound member and provider calls on a clinical phone queue. Ensure members receive behavioral health services appropriate to clinical need. Triage crisis calls to assist with stabilization and access to emergency evaluation. Coordinate services with other departments, such as medical case/care management. Perform utilization management functions, including authorization determinations and care shaping. Handle member calls, performing activities such as telephonic clinical assessment, determining appropriate level of care and services and answering...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Conduct screening and risk assessment interventions per program guidelines. • Identify special needs members through the completion of health screens and other resources. • Work with community outreach/member advocates to coordinate member care. • Educate providers and community resources on program components and available support services. • Educate members with special needs to foster compliance with program and positively impact outcomes. • Conduct site visits as appropriate for programs and provide support to other special programs. • Develop and modify care plans in conjunction with member, member’s family and managing physician. • Development of plan specific literature and...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. • Develop, assess and adjust, as necessary, the care plan and promote desired outcome • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients • Develop plan of care based upon...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. REMOTE WORK - Ellis County or Navarro County, TX: Service members in Alma, TX, Ennis, TX, Avalon, TX Italy, TX, Corsicana, TX, Rice, TX, or Waxahachie, TX. As a Behavioral Health Care Manager, you will: Perform care management duties for members with serious and persistent mental illness (SPMI) including assessing, planning and coordinating all aspects of behavioral health services across the continuum of care to promote quality, cost effective care. Behavioral Health Care Managers may also handle crisis calls. • Bi-annually assess the member’s current health status to include physical and behavioral health needs.  Enter and maintain assessments, authorizations, and pertinent clinical information...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: The Case Manager/Care Coordinator II is responsible for the coordination of services and cost effective management of health care resources to meet individual members’ health care needs and promote positive health outcomes. Acts as a member advocate and a liaison between providers, members and HN to seamlessly integrate complex services. Case Management services are generally focused on members who fall into one or more high risk or high cost groups and require significant clinical judgment, independent analysis, critical-thinking, detailed knowledge of departmental procedures, clinical guidelines, community resources, contracting and community standards of care. Case Management...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. San Antonio, TX Hybrid position - Work from home and some travel to conduct IN-PATIENT behavioral health assessments. As a Behavioral Case Manager, you will: 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 issues. 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 goals. Empower patients to help them improve their quality of life...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. 100% Remote Work in Texas: Yes - flexibility to work remote from home anywhere in Texas. Requirement: Must have an active and current unrestricted license: LCSW, LPC, LMFT, LPCC, or have a PhD for the state of Texas. As a Behavioral Health Clinical Care Manager (STAFF Level), you will: Handle inbound and outbound member and provider calls on a clinical phone queue. Ensure members receive behavioral health services appropriate to clinical need. Triage crisis calls to assist with stabilization and access to emergency evaluation. Coordinate services with other departments, such as medical case/care management. Perform utilization management functions, including authorization determinations and care...

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. NOTE: Remote role for public health applicants who reside in or very close to the border of Kansas state. There may be up to 10% travel to the Kansas office(s) for meetings. This role involves analyzing HEDIS/STARS data and collaborating with internal and external stakeholders to ensure HEDIS and STARS initiatives are fully integrated throughout the organization, maximizing opportunity to improve outcomes for members. Certified Professional in Healthcare Quality (CPHQ) is preferred. Position Purpose: Plans, organizes, and monitors quality related projects to deliver defined requirements and meet company strategic objectives. • Support enterprise-wide quality initiatives by analyzing and...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. THIS POSITION IS REMOTE/WORK FROM HOME WITH TRAVEL APPROX. 50% OF THE TIME TO VISIT MEMBERS IN THEIR HOMES IN THE FOLLOWING IL COUNTIES (MUST RESIDE IN ONE OF THESE COUNTIES): EFFINGHAM, JASPER, CRAWFORD, WAYNE, RICHLAND, HAMILTON AND WHITE Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. • Develop, assess and adjust, as necessary, the care plan and promote desired outcome • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and...

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Provides facilitation, assessment, content development, teaching and monitoring of educational programs. Responsible for onboarding and mentoring new Learning and Development specialists in their first 90 days. Mentors and supports the ongoing development of new and existing. Learning and Development Specialist. Provides instructional design support to key learning and development delivery projects. Leads learning and development projects supporting enterprise initiatives, including market acquisitions and expansions. Monitors, analyzes and reports on feedback trends. Responsibilities: Trains, facilitates and assesses training programs for Centene Clinical and Non-clinical...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. THIS POSITION IS REMOTE/WORK FROM HOME WITH UP TO 50% TRAVEL TO VISIT MEMBERS IN THEIR HOMES IN THE PEORIA, IL AREA. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. • Develop, assess and adjust, as necessary, the care plan and promote desired outcome • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for day-to-day oversight of the Integrated Care Managers and coordination of necessary resources for members. This may include adequate clinical, behavioral, acute/chronic, and social care services. - Ensure staff is able to facilitate member and provider needs through entire care management cycle. - Partner with internal staff on key initiatives and outreach for members as needed. - Coordinate and communicate on access issues, assessments, internal protocols. - Implement policies and procedures through oversight for complex cases and present to management - Assist in recruitment efforts in accordance to the staff to member ratio - Coordinate the training of care...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. 100% REMOTE IN TEXAS - Applicants must be fully licensed for the state of Texas with one of the following: LPC, LCSW, LMFT, LPCC, PsyD, or PhD. As a Behavioral Health Clinical Care Manager, you will: Perform utilization review functions with behavioral health providers, including authorization determinations and care shaping. Handle inbound and outbound member and provider calls on a clinical phone queue. Ensure members receive behavioral health services appropriate to clinical need. Coordinate services with other departments, such as medical case/care management. Handle member calls, performing activities such as telephonic clinical assessment, determining appropriate level of care and services...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. This position is 50% field based in New Jersey covering the Hudson/Essex area. Conducts comprehensive member psychosocial assessments through root cause analysis and performs clinical intervention through the development of a care management treatment plan specific to each member with high level acuity needs. Manages members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability. Assess members to recommend activities and behavioral routines to meet the social and medical needs of members and their families. Provides support and/or intervention and assists members in understanding the implications and complexities of their current...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for day to day oversight of the Service Coordinators and coordination of necessary resources for members. This may include adequate clinical, behavioral, acute/chronic, and social care services. • Develop and implement appropriate policies and procedures • Ensure staff is able to facilitate member and provider needs through entire case management cycle • Partner with internal staff on key initiatives and outreach for members as needed • Coordinate and communicate on access issues, assessments, internal Managed Care Organization (MCO) protocols • Create effective organizational structure, roles and jobs • Compile and review multiple reports on work function and for...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Conduct screening and risk assessment interventions per program guidelines. • Identify special needs members through the completion of health screens and other resources. • Work with community outreach/member advocates to coordinate member care. • Educate providers and community resources on program components and available support services. • Educate members with special needs to foster compliance with program and positively impact outcomes. • Conduct site visits as appropriate for programs and provide support to other special programs. • Develop and modify care plans in conjunction with member, member’s family and managing physician. • Development of plan specific literature and...