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clinical case manager, behavioral health Jobs in Iowa

clinical case manager, behavioral health

clinical pharmacist

CVS Health

<div><p>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.</p><p></p><div><div><p>
We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.</p></div><div><ul><li><p>
Starting hourly rate $15.00, with unlimited bi-weekly commission potential.</p></li></ul></div><div><ul><li><p>
10 days of required paid training (Monday-Friday, 8AM-4:30PM CST)</p></li></ul></div><div><ul><li><p>
Call center hours of operation are Monday-Sunday 7AM &ndash; 7PM; actual shift will be determined at time of hire.</p></li></ul></div><div><ul><li><p>
Competitive benefits, PTO, tuition reimbursement, and more!</p></li></ul></div><div><p><b>
How will this role have an impact?</b></p></div><div><p>
At Signify Health, we value and seek exceptional thinkers with the heart and humility to match. Join us on a mission to improve lives and make a lasting difference.</p></div><div><p>
As a Member Engagement Coordinator, you will contact members of various Medicare Advantage and Medicaid health plans by phone to offer, explain, and schedule a free in-home or virtual healthcare evaluation. You will work diligently to meet department productivity, quality, and customer service goals.</p></div><div><p>
This role will report to a Member Engagement Manager.</p></div><div><p><b>
What will you do?</b></p></div><div><ul><li><p>
Make an average of 50 outbound calls per hour placed by an automatic dialer system to offer, explain, and schedule a free in-home or virtual health evaluation with a provider</p></li></ul></div><div><ul><li><p>
Follow 20+ approved scripts, ensure members understand and are comfortable with the terms, and respond to rebuttals persuasively and with professional courtesy</p></li></ul></div><div><ul><li><p>
Present a positive, professional, and high energy approach to clients, health plan members, and team members</p></li></ul></div><div><ul><li><p>
Meet daily goals set by the department (i.e., 300-400 outbound dials per day, 25 appointments set per day, shift and attendance policy adherence, quality targets, etc.) in an office or remote environment</p></li></ul></div><div><ul><li><p>
Adjust, reschedule, and cancel appointments with both members and contracted providers, as requested</p></li></ul></div><div><ul><li><p>
Monitor performance results including appointments, calls, handle time, and productivity using designated reporting systems</p></li></ul></div><div><ul><li><p>
Report member complaints and escalations immediately to Member Engagement Managers</p></li></ul></div><div><ul><li><p>
Participate in peer side-by-side coaching as needed</p></li></ul></div><div><ul><li><p>
Follow HIPAA and other security and privacy guidelines when handling protected health information accessed during normal work activities</p></li></ul></div><div><p><b>
We are looking for someone with:</b></p></div></div><div><div><ul><li><p>
A High School Diploma or equivalent is preferred</p></li></ul></div><div><ul><li><p>
1+ year call center experience OR 2+ years general work experience required</p></li></ul></div><div><ul><li><p>
Previous outbound call center or high volume experience working in a metrics driven environment, with an auto dialer, and/or using scripts is preferred</p></li></ul></div><div><ul><li><p>
A desire to work in an efficient, results-oriented outbound call center environment</p></li></ul></div><div><ul><li><p>
Persuasive with the ability to rebuttal while treating all health plan members with professional courtesy</p></li></ul></div><div><ul><li><p>
Good communication skills, friendly and conversational</p></li></ul></div><div><ul><li><p>
Ability to adhere to a fixed daily schedule, including start, breaks, lunch, and end times</p></li></ul></div><div><ul><li><p>
Strong computer skills and the ability to use multiple systems at the same time, while making calls</p></li></ul></div><div><p><b>
Benefits:</b></p></div><div><ul><li><p>
Medical, Dental and Vision plans, Insurance starts the 1st of each month after the start date</p></li></ul></div><div><ul><li><p>
Bi-weekly pay with monthly commission bonus potential</p></li></ul></div><div><ul><li><p>
401K, employee stock purchase program and tuition reimbursement</p></li></ul></div><div><ul><li><p>
Employee discount programs</p></li></ul></div><div><p><b>
Work From Home Requirements:</b></p></div><div><p>
To qualify, you must have verified and reliable internet service with 10MB upload/download ability available in your home.</p></div><div><p>
The company will provide equipment (keyboard, monitor, computer, headset, etc.). All applicants must provide their own workspace furniture and ensure a quiet workspace.</p></div><div><p><b>
Conditions of Employment:</b></p></div><div><p>
Successful completion of background check is required for this position.</p></div><div><p><b>
Anticipated Weekly Hours</b></p></div><div><p>
40</p></div></div><div><p><b>
Time Type</b></p></div><div><p>
Full time</p></div><div><p><b>
Pay Range</b></p></div><div><p>
The typical pay range for this role is:</p></div><div><p>
$15.00 - $26.93</p></div><div><p>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.</p></div><div><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p></div><div><p><b>
Great benefits for great people</b></p></div><div><p>
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.</p></div><div><p><br>
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.</p></div><div><p>
Additional details about available benefits are provided during the application process and on Benefits Moments.</p></div><div><p><br>
We anticipate the application window for this opening will close on: 05/31/2026</p></div><div><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$15.00 - $26.93<p></p><p>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.</p><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.</p><br>
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.<p><br>
Additional details about available benefits are provided during the application process and on Benefits Moments.</p><br>
We anticipate the application window for this opening will close on: 04/29/2026<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Outbound Call Center Rep

ELEVATE CCBHC

<div><p>When our neighbors are hurting, we want to help in the healing. Come join us at ELEVATE, where our goal is to set the bar higher. We are a group of deeply committed people working together to provide each member-client with the services and assistance they need for meaningful progress in leading their best life. Our mission is to elevate care by serving our members when, where, and how they want.</p>
<p><b>
Position Summary:</b></p>
<p>
Mobile Response Team members are paid to be on call at all times. If called to a mental health crisis in the community they will respond in pairs or with law enforcement.</p>
<p>
No two days are ever the same, but as the mobile Crisis Response team Member, you will:</p>
<ul>
<li>Function as an effective team member and represent Elevate in a professional manner, complete related data entry, paperwork, and notify Elevate after call is completed</li>
<li>Be accessible by telephone and prepared to respond to calls during all scheduled shifts, arrive at any client location within one hour of being called, coordinating arrival with co-worker in any situation requiring a two-person response and develop and maintain working relationships with other mental health practitioners, case managers, law enforcement officers, school personnel, hospital personnel, and other interested parties</li>
</ul>
<p><b>Shift: Available 7:00am-7:00pm about 20-29 hours</b></p>
<p><b>
Job Responsibilities:</b></p>
<p>
One of the following educations and/or training qualifications must be met:</p>
<p>
1. A mental health professional as defined in Iowa Code section 228.1</p>
<p>
2. A bachelor&rsquo;s degree with 30 semester hours or equivalent in a human services field (including, but not limited to, psychology, social work, nursing, education) and a minimum of one year of experience in behavioral or mental health services</p>
<p>
3. A law enforcement officer with a minimum of two years of experience in the law enforcement officer&rsquo;s field</p>
<p>
4. An emergency medical technician (EMT) with a minimum of two years of experience in the EMT&rsquo;s field</p>
<p>
5. A peer support specialist with a minimum of one year of experience in behavioral or mental health services</p>
<p>
6. A family support peer specialist with a minimum of one year of experience in behavioral or mental health services</p>
<p>
7. A registered nurse with a minimum of one year of experience in behavioral or mental health services</p>
<p>
8. A bachelor&rsquo;s degree in a non-human services-related field, associate&rsquo;s degree, or high school diploma (or equivalency) with a minimum of two years of experience in behavioral or mental health services, and 30 hours of crisis and mental health in-service training (in addition to the required 30 hours of department-approved training</p>
<ul>
<li>Dependable transportation</li>
<li>Possess a valid driver&rsquo;s license and provide a certified driving record if transporting clients or coworkers</li>
<li>Working telephone or means to accept dispatch calls</li>
<li>Ability to work a flexible schedule including nights and weekends</li>
</ul>
<div><b>Benefits</b></div>
<ul><li> <b>Competitive salary at $18.54 an hour</b></li></ul>
<ul><li> Medical, Dental and Vision plans</li></ul>
<ul><li> Vacation plan</li></ul>
<ul><li> Paid Time Off</li></ul>
<ul><li> Flexible schedule</li></ul>
<ul><li> Ability to work remotely</li></ul>
<p><b>
Qualifications:</b></p>
<ul>
<li>Crisis Intervention with experience in suicide intervention, and postvention</li>
<li>Must be available from 7am-7pm</li>
<li>Current valid Drivers License</li>
<li>Knowledge of community resources</li>
<li>Experience assisting people with addiction, relationship difficulties, depression, stress, extreme poverty, mental illness, parenting etc.</li>
</ul>
<p> ELEVATE is an equal opportunity/affirmative action employer. All qualified applicants are encouraged to apply and will receive consideration for all employment; free from discrimination based on race, creed, color, national origin, age, sex, pregnancy, sexual orientation, gender identity, genetic information, religion, associational preferences, status as a qualified individual with a disability, or status as a protected veteran.</p></div><p></p>

Mobile Crisis Responder

GROW IOWA FOUNDATION, INC.

<p><b>Position Overview</b></p><p>Grow Iowa Foundation seeks a dynamic and mission-driven Executive Director to lead the organization&rsquo;s lending and economic development initiatives. This individual will provide strategic leadership, oversee daily operations, manage lending activities, and advance GIF&rsquo;s mission to promote housing and economic development throughout southwest Iowa.</p><p>The Executive Director will work closely with the Board of Directors, Loan Review Committee, community stakeholders, borrowers, and funding partners to ensure strong portfolio performance and organizational growth.</p><p><b>Key Responsibilities</b></p><p>● Market GIF&rsquo;s business and housing loan funds and respond to borrower and partnerinquiries</p><p>● Coordinate activities of the Loan Review Committee and contracted document/closingspecialists</p><p>● Maintain accurate and complete loan files and databases</p><p>● Monitor and service the loan portfolio, including scheduling site visits and housinginspections</p><p>● Prepare reports on borrower inquiries, lending activity, and loan repayment schedules</p><p>● Lead capitalization efforts for lending pools, including grant solicitation, compliance, andinvestor relations</p><p>● Develop and maintain marketing materials to promote GIF programs and impact</p><p>● Represent GIF within the service area and strengthen partnerships with communitiesand stakeholders</p><p>● Complete additional assignments as directed by the Board of Directors</p><p><b>Qualifications &amp; Skills</b></p><p>The ideal candidate will possess:</p><p>● A strong commitment to housing and economic development</p><p>● Demonstrated leadership and organizational management skills</p><p>● Strong marketing and relationship-building abilities</p><p>● Experience working with a diverse range of borrowers and community partners</p><p>● Excellent written and verbal communication skills</p><p>● High initiative and the ability to manage multiple projects effectively</p><p>● Strong attention to detail</p><p>● Ability to work independently and collaboratively</p><p><b>Required:</b></p><p>● Proficiency in Microsoft Office, including Excel</p><p><b>Preferred:</b></p><p>● Experience in lending, finance, community development, or nonprofit management</p><p><b>Compensation &amp; Benefits</b></p><p>● Salary commensurate with experience</p><p>● Two weeks paid vacation</p><p>● Paid holidays and sick leave (pro-rata)</p><p><b>About Grow Iowa Foundation</b></p><p>Grow Iowa Foundation, Inc. (GIF) is a 501(c)(3) organization dedicated to strengthening communities across southwest Iowa. GIF provides financing to businesses, cities, counties, and private developers to support business creation and expansion and community improvement projects. Funds are available for housing projects through business funds to private or community contractors.</p><p>Headquartered in Lenox, Iowa, GIF manages several business relending and housing development loan funds. GIF is a certified Community Development Financial Institution (CDFI) and Community Housing Development Organization (CHDO).</p><p>GIF serves the following 21 counties in southwest Iowa:</p><p>Monona, Crawford, Carroll, Greene, Harrison, Shelby, Audubon, Guthrie, Pottawattamie, Cass, Adair, Mills, Montgomery, Adams, Union, Clarke, Fremont, Page, Taylor, Ringgold, and Decatur. (Not all programs are eligible in every county.)</p><p>This position may be performed remotely; however, the Executive Director must reside within one of the 21 counties served.</p><p>Grow Iowa Foundation is committed to strengthening communities across southwest Iowa through responsible lending and strategic investment. We encourage candidates who are passionate about rural economic development and affordable housing to apply.</p><p><b>Application Procedure</b></p><p>Please submit resumes and cover letters detailing relevant skills, experience &amp; compensation history via mail or email to: director@growiowa.org</p><p>Grow Iowa Foundation, Inc. is an &ldquo;Equal Opportunity Employer&rdquo; and an &ldquo;Equal Opportunity Provider.&rdquo;</p><p>Pay: From $15,500.00 per year</p><p>Benefits:</p><ul><li>Paid time off</li></ul><p>Work Location: Remote</p>

Executive Director

Trustwell Living

<div><p>Do you love helping others and being the friendly first face people see? In our community, residents and their families count on us for comfort, connection, and care. As a Concierge, you&rsquo;ll be at the heart of that mission, making each day a little brighter for those we serve. Join our team as a <b>Concierge/Receptionist</b>, where you&rsquo;ll play an essential role in creating a warm, welcoming experience for residents, families, and visitors.</p><br>
<p>
</p><p><b>What You&rsquo;ll Do:</b></p>
<ul>
<li>Greet residents, families, and guests with a smile and provide outstanding customer service.</li>
<li>Answer phone calls, direct inquiries, and assist with community information.</li>
<li>Support residents with day-to-day needs such as scheduling and coordinating appointments.</li>
<li>Safely transport residents to and from scheduled appointments, ensuring their comfort along the way.</li>
<li>Receive deliveries and assist with coordinating services for residents.</li>
<li>Assist with light administrative tasks such as filing, scheduling, or data entry.</li>
<li>Help maintain the reception area to ensure it&rsquo;s always welcoming and professional.</li>
<li>Partner with other team members to make sure residents feel supported, comfortable, and cared for.</li></ul><br>
<p></p>
<p><b>
What We&rsquo;re Looking For:</b></p>
<ul>
<li>A positive, professional, and approachable demeanor.</li>
<li>Strong communication and organizational skills.</li>
<li>Ability to multitask and handle a variety of requests with patience and kindness.</li>
<li>Previous customer service, hospitality, or administrative experience preferred.</li>
<li>Compassion and respect for older adults and their families.</li>
<li>A valid driver&rsquo;s license with a good driving record.</li></ul><br>
<p></p>
<p><b>
Why Join Us?</b><br>
At Trustwell, we believe in creating a work environment that fosters growth and satisfaction. We offer competitive compensation, comprehensive benefits, and opportunities for professional development. By joining our team, you&rsquo;ll become part of a community that values care and compassion toward its senior residents. We strive to build an inclusive work environment that celebrates differences and empowers all individuals with opportunities to channel their entrepreneurial spirit. Trustwell is an EEO employer.</p><br>
<p></p>
<p>
IND100</p></div>

Concierge/Receptionist

<div><p>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.</p><p></p><p><b>
Position Summary:</b>
</p><p>Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes.</p><p></p><p><br>
Assessment of Members:</p><ul><li><p>
Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member&rsquo;s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member&rsquo;s benefit plan and available internal and external programs/services.</p></li><li><p>
Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues.</p></li><li><p>
Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated.</p></li><li><p>
Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services.</p></li></ul><p></p><p>
Enhancement of Medical Appropriateness and Quality of Care:</p><ul><li><p>
Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member&rsquo;s needs to ensure appropriate administration of benefits</p></li><li><p>
Using holistic approach consults with supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary view in order to achieve optimal outcomes</p></li><li><p>
Identifies and escalates quality of care issues through established channels</p></li><li><p>
Ability to speak to medical and behavioral health professionals to influence appropriate member care.</p></li><li><p>
Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promotes lifestyle/behavior changes to achieve optimum level of health</p></li><li><p>
Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.</p></li><li><p>
Helps member actively and knowledgably participate with their provider in healthcare decision-making</p></li><li><p>
Analyzes all utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs.</p></li></ul><p></p><p><br>
Monitoring, Evaluation and Documentation of Care</p><ul><li><p>
In collaboration with the member and their care team develops and monitors established plans of care to meet the member&rsquo;s goals</p></li><li><p>
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.</p></li><li><p>
Ability to take and manage crisis calls.</p></li></ul><p></p><p><b><br>
Required Qualifications:</b></p><ul><li><p>
Unencumbered Independent Behavioral Health clinical license in the state where they reside and work:</p></li></ul><h3 class="jobSectionHeader"><b>
Licensed Mental Health Counselor (LMHC)</b></h3><h3 class="jobSectionHeader"><b>
Licensed Clinical Social Worker (LCSW)</b></h3><h3 class="jobSectionHeader"><b>
Licensed Independent Social Worker (LISW)</b></h3><h3 class="jobSectionHeader"><b>
Licensed Marital and Family Therapist (LMFT)</b></h3><h3 class="jobSectionHeader"><b>
Licensed Professional Counselor (LPC)</b></h3><ul><li><p>
3+ years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility</p></li><li><p>
3+ years minimum of Behavioral Health experience</p></li><li><p>
Applicants must be willing to work standard business hours in EST or CST.</p></li></ul><p><br>
</p><p><b>Preferred Qualifications</b></p><ul><li><p>
Case management and discharge planning experience
</p></li><li><p>Crisis intervention skills
</p></li><li><p>Managed care/utilization review experience
</p></li><li><p>Ability to take and manage crisis calls</p></li></ul><p></p><p><b>
Education</b></p><p>
Minimum of a Master&rsquo;s degree in Behavioral/Mental Health or related field</p><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$54,095.00 - $142,576.00<p></p><p>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.</p><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.</p><br>
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.<p><br>
Additional details about available benefits are provided during the application process and on Benefits Moments.</p><br>
We anticipate the application window for this opening will close on: 05/02/2026<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Clinical Case Manager, Behavioral Health

Centene

<div><p>You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you&rsquo;ll have access to competitive benefits including a fresh perspective on workplace flexibility.<br>
</p><p><b>**Applicants for this role have the flexibility to work remotely from their home anywhere within the state of Iowa**</b></p><p><b>
Position Purpose:</b> Supervises the care management team and the care coordination of behavioral health members to promote quality and efficacy of care management delivery related to mental and behavioral health needs. Supervises day-to-day escalations and care management issues related to members or providers.</p><ul><li>
Monitors and reviews care management required documentation to maintain compliance with federal and state regulations and contractual agreements</li><li>
Assigns caseloads to care management staff based on state requirements, care management staff experience, and member needs</li><li>
Works with senior management on escalated and complex care cases related to BH and provides guidance to junior team members to address member concerns</li><li>
Educates and provides resources for care management team on key initiatives and member outreach</li><li>
Evaluates care management team performance and provides feedback regarding performance, goals, and career milestones</li><li>
Provides coaching and guidance to care management team and providers to ensure members are receiving high quality care and information regarding service / care plan options, procedures, referrals, and healthcare benefits</li><li>
Monitors and review reports on a regular basis ensuring quality and productivity metrics are met and for case assignments, and may perform audits of staff on a regular basis</li><li>
Assists with onboarding, hiring, and training care management team members</li><li>
Performs other duties as assigned.</li><li>
Complies with all policies and standards.</li></ul><p><b>
Education/Experience:</b> Requires a Master's degree or Graduate from an Accredited School of Nursing and 4+ years of related experience.<br>
<br>
<b>License/Certification:</b></p><ul><li>
Licensed Clinical Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, and RN with BH experience required</li></ul>
Pay Range: $87,000.00 - $161,300.00 per year<p>
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.</p><p>
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.</p><p><br>
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act</p></div>

Supervisor, Care Management

<div><p>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.</p><p></p><p><b>
Position Summary</b></p><p>
We are seeking a highly motivated and strategic professional to serve as the Medicaid Market Manager for our Risk Adjustment programs. This is a high-visibility role responsible for driving market level engagement, delivering insights, and demonstrating the value of Medicaid risk adjustment performance to senior leaders and market partners.</p><p>
The Medicaid Market Manager will serve as the key connector between national Risk Adjustment strategy and market execution, ensuring alignment, accountability, and measurable impact. The individual in this role will lead monthly market meetings, translate performance data into actionable insights, and collaborate with cross functional partners to enhance provider engagement and member outcomes.<br>
1. <b>Market Lead &amp; Performance Management</b></p><ul><li>
Function as a face of Revenue Integrity across internal market teams.</li><li>
Develop and deliver executive level presentations highlighting key performance drivers, challenges, and solutions.</li><li>
Investigates operational issues that impact market performance &ndash; work with business partners to implement solutions.</li><li>
Track deliverables and identify barriers in market engagement in conjunction with implementing resolutions.</li><li>
Assist with development of educational material to support market intelligence.</li><li>
Engage with market clinical team, care management team, member services team; attend market level meetings as appropriate.</li><li>
Apply project management skills to coordinate deliverables, track timelines, and manage competing priorities.</li></ul><p><b>
2.Data Analysis &amp; Reporting</b></p><ul><li>
Work closely with the Informatics team to review requirements, dashboards, reports including any enhancements.</li><li>
Utilize data analyses using national tools in conjunction with the corporate lead to identify areas of opportunity.</li><li>
Produce and present market specific performance specific to Medicaid Revenue Integrity efforts at various governance, market, and executive leadership meetings.</li></ul><p><b>
3. Strategy &amp; Execution</b></p><ul><li>
Monitors program or programs that are jointly accountable for risk adjustment strategy, performance, and results within a designated market(s).</li><li>
Responsible for identifying and recommending nuanced market risk adjustment strategies and collaboratively executing tactics to focus, maximize and achieve market success, including market referrals.</li><li>
Coordinate with local markets to drive correctness, completeness, accuracy, and timeliness of risk score performance.</li><li>
Collaborate on market specific strategies that drive member engagement in risk adjustment programs.</li><li>
Stay abreast of regulatory changes and leading risk adjustment practices and tools to maximize the effectiveness and efficiency of the team.</li><li>
Partner with segment product, sales, network, clinical teams to implement processes aimed at strengthening member and provider engagement of Revenue Integrity programs resulting in improved outcomes.</li></ul><p></p><p><b>
Required Qualifications</b></p><p>
5+ years of progressive experience in healthcare operations, risk adjustment or related fields</p><p>
2+ years analyzing performance data and building executive-ready narratives and materials that translate findings into clear recommendations (KPIs, trends, variance drivers, and actions).</p><p>
3+ years leading cross-function projects, managing project plans/timelines and routing status reporting.</p><p>
Strong presentation skills with ability to clearly communicate complex information to diverse audiences, including senior leadership</p><p>
Proven track record of leading and supporting meetings by capturing detailed, accurate notes, key decisions and action items.</p><p>
Advanced proficiency in Microsoft PowerPoint; including ability to create clear, visually compelling, executive-level presentations.</p><p>
Strong working knowledge of Microsoft Excel, with experience building tables, charts and dashboard to synthesize and communicate data effectively</p><p>
Ability to translate complex data into concise actionable insights using visuals and structured storytelling.</p><p>
Rigorous follow up on takeaways, driving accountability and timely completion of next steps across stakeholders.</p><p>
Knowledge of insurance regulatory and contractual requirements.</p><p>
Self-starter who demonstrates initiative and displays a high energy level.</p><p>
Intellectual curiosity and tenacity: strong ability to learn on the fly; to understand and solve complex problems.</p><p>
Proven ability to lead projects end to end.</p><p></p><p><b>
Preferred Qualifications</b></p><p>
Experience delivering presentations to Senior Executives and Provider groups</p><p>
Master&rsquo;s degree or management development program preferred.</p><p>
2+ years of experience in Medicaid operations, risk adjustment, or medical coding and documentation</p><p>
Deep knowledge of local markets across Aetna Medicaid.</p><p><b><br>
Education</b></p><p>
Bachelor&rsquo;s Degree or equivalent work experience</p><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$54,300.00 - $145,860.00<p></p><p>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.</p><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.</p><br>
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.<p><br>
Additional details about available benefits are provided during the application process and on Benefits Moments.</p><br>
We anticipate the application window for this opening will close on: 05/31/2026<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Medicaid Risk Adjustment Market Manager

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