Health services manager job description

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.

Locations: Work remote from home and service members in Abilene, TX, El Paso, TX San Angelo, TX Wichita Falls, TX and surrounding areas.

Hybrid position - Work from home and travel within the assigned service delivery area(s) to conduct behavioral health assessments and service coordination for members with child behavioral health conditions and special needs.
As a Behavioral Health Service Mgr, you will:

Perform duties related to the day-to-day operations of the Service Management functions for STAR Kids members to achieve the highest possible levels of functioning and wellness by ensuring consistent, timely access to medically necessary behavioral health services. Monitor quality of care, assist with discharge planning.• Work with Members, Medical Consenters, clinical staff and providers to meet the behavioral healthcare needs of each member’s condition.
• Identify members who may benefit from service management, conduct an assessment and develop, implement and monitor a behavioral healthcare service plan.
• Provide information to clinical staff to facilitate development of the behavioral healthcare service plan.
• Update database regularly with most recent Service Management Plan of Care.
• Review information submitted by providers into the database to ensure material is appropriate and consistent with guidelines for data inclusion.
• Encourage behavioral health providers to use evidence-based practices and confirm that behavioral health providers and PCP’s are sharing information as required.
• Comply with established referral, pre-certification and authorization policies, procedures and processes by related medical management staff.
• Maintain compliance with federal and state regulations and contractual agreements.
• Coordinate service management functions with other departmental functions.
• Monitor data to address trends or potential quality improvement opportunities.
• Maintain HIPAA compliance and travel to member's homes to conduct assessments.
Education/Experience:
Master's degree in relevant field (e.g. social work, counseling, psychology) OR Associates/Bachelor’s degree in Nursing specializing in psychiatric/mental health. 3+ years of direct behavioral health/psychiatric experience, case management, utilization management, service coordination. Experience in psychiatric health care settings, child behavioral health conditions and members with special needs. Working knowledge of utilization review procedures, and familiarity with mental health community resources. Managed care is preferred, but not required.
License/Certification: Unrestricted license as a LCSW, LMFT, LPC, or RN in the applicable state is required. Driver’s license is required.
Work From Home TEXAS: Must reside in Abilene, El Paso, San Angelo, Wichita Falls, and surrounding TX areas
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
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.

WE SERVE ALL. WE HIRE ALL. WE ACCEPT ALL.

Now interviewing for a Manager for our Social Drivers of Health Team!

Remote/In-person hybrid position. Must live in Indiana

Aspire Indiana Health is a nonprofit provider of comprehensive "whole health" services including primary medical care, behavioral health, recovery services and programs addressing the social drivers of health such as housing and employment. Aspire has health centers in five Central Indiana counties serving Hoosiers of all ages and walks of life.

Position Summary

The Manager Social Drivers of Health (SDoH) will implement day-to-day management and oversight of strategic programs (e.g. housing, employment, etc.) ensuring accuracy and customer satisfaction for each program. This position provides leadership, direction and administrative oversight in advancing and supporting Aspire's mission, vision, values, and strategic priorities.

Education/Experience/Requirements

+ Bachelor's degree from a college/university accredited by the U.S. Department of Education with two (2) years of related experience; an Associate's Degree with with three (3) years of related experience, or a high school diploma or equivalent with at least five (5) years of related experience required

+ At least (1) year of experience leading a team required

+ Experience with housing or employment preferred

+ Experience with third party contracts preferred

+ Healthcare and/or non-profit experience and a solid understanding of the behavioral health field highly preferred

Learn more about us at Aspireindiana.org, and see our Core Values, Benefits and Current Job Listings on our Careers page. Or check out our Facebook, LinkedIn, Twitter and YouTube pages.

Drug screen, TB test and extensive background checks (including Criminal History, Sex Offender Registry Search, State Central Registry Check, Education Verification, and Professional References) are required of all Aspire employees.

All individuals who join Aspire are strongly encouraged to have a flu shot and required to be fully vaccinated against COVID19 prior to joining Aspire to further protect our staff and the patients we serve. We also adhere to CDC protocols including wearing masks, social distancing, and sanitizing.

Aspire Indiana Health is an Equal Opportunity Employer.


External Company Name: Aspire Indiana Health, Inc.

Street: 697 Pro-Med Lane

A higher degree of healthcare.

All across UW Medicine, our employees collaborate to perform the highest quality work with integrity and compassion and to create a respectful, welcoming environment where every patient, family, student and colleague is valued and honored.

At UW Medical Center - Northwest (formerly Northwest Hospital & Medical Center), we're proud of the acclaim we've received for our excellence in patient care and safety. Among the local, regional and national recognition we've received are: The Distinguished Hospital for Clinical Excellence Award; The Stroke Care Excellence Award; Winner of the HealthGrades Distinguished Hospital Award for Patient Safety for the last three years in a row. We're also one of the safest places to get care - among the top 5% in the country.

UW Medical Center - Northwest is a full-service medical center based in North Seattle. We are a non-profit community hospital offering comprehensive medical, surgical and therapeutic services. With 281 beds, more than 2,000 employees and a world-class medical staff, we provide innovative, technologically advanced care on a patient-friendly, easy-access campus, just north of Seattle.

Teamwork. Community. Opportunity. Become part of our team, and join our mission to make life healthier for everyone in our community.

UW Medical Center - Northwest has an outstanding opportunity for a full-time (100% FTE, 40 hours per week), day shift HEALTH SERVICES MANAGER

RESPONSIBILITIES:

Under the guidance of the Assistant Administrator, assists with development, planning, and implementation of departmental goals and objectives.

Prepares employee schedules and assigns work to staff. Evaluates daily workload and makes adjustments in staff assignments.

Conducts ongoing operational assessments. Identifies, plans, implements, and drives improvements.

Monitors billing, collections, coding, and insurance systems to ensure regulatory compliance and maximum reimbursement.

Develops key financial criteria and standardized financial reports, and presents reports to clinic physicians and hospital administration.

Establishes and updates standards, procedures, and policies. Monitors employee compliance with regulatory requirements.

Monitors data to evaluate department productivity and maintain a cost effective unit.

Maintains appropriate documentation for accreditation.

Resolves patient complaints, concerns, or issues.

Develops, coordinates, and evaluates training programs for staff.

Has primary responsibility for insurance contracting and credentialing.

REQUIREMENTS:

Bachelor's Degree in Business Administration, Healthcare Administration, or a related field; OR equivalent experience

2-3 years of management or supervisory experience in a healthcare setting

UW Medicine includes Harborview Medical Center, UW Medical Center - Montlake, UW Medical Center - Northwest, Valley Medical Center, UW Neighborhood Clinics, UW Physicians, UW School of Medicine, and Airlift Northwest.

Applicants considered for this position will be required to disclose if they are the subject of any substantiated findings or current investigations related to sexual misconduct at their current employment and past employment. Disclosure is required under Washington state law.