Centene Corporation Supervisor, Clinical in Detroit, Michigan
ProfessionalPosition 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.
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.
TITLE: Supervisor, Clinical
LOCATION: Detroit, Michigan
COMPANY: Clinical & Nursing, Leadership
POSITION TYPE: Professional