Lead Care Manager

Centene Corporation

. Oversee care plans and care management activities for members with complex behavioral health and social needs .

Posted 10/23/2026full-timeRemote • North Carolina • United StatesSenior💰 $87,000 - $161,300 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in overseeing complex behavioral health care plans and managing care management activities, ensuring compliance with NCQA standards and state regulations. Proficient in collaborating with healthcare providers and training care management teams to enhance quality delivery and cost-effective care.

Highest-signal resume keywords

Licensed Master's Behavioral Health ProfessionalBehavioral Health ExperienceKnowledge of NCQA StandardsComplex Care Plan OversightPediatric Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care Management ActivitiesBehavioral Health Care PlansQuality Control MonitoringData Review and AnalysisTelephonic OutreachTriage Complex IssuesDocumentation and MaintenanceTraining and EducationCompliance MonitoringCase Assignment Management

Soft Skills

Leadership SupportCollaborationCommunicationProblem-SolvingTeam Guidance

Certifications & Qualifications

Licensed Clinical Social Worker (LCSW)Licensed Professional Counselor (LPC)Licensed Marriage and Family Therapist (LMFT)Licensed Mental Health Counselor (LMHC)Registered Nurse (RN)

Industry Keywords

Behavioral HealthSocial WorkPediatric CareState and Federal RegulationsThird-Party Payer RequirementsCare ManagementNCQA StandardsHealth RisksCare GapsQuality Delivery

About the role

Key responsibilities & impact

Oversee care plans and care management activities for members with complex behavioral health and social needs
Review and provide expert knowledge for personalized care plans
Guide and support the care management team
Identify providers, specialists, and community resources needed for care
Conduct telephonic, digital, home, and/or other site-visit outreach to assess member needs
Triage complex issues to appropriate behavioral healthcare providers
Ensure quality control, service accessibility, and adherence to contract policies and procedures
Monitor complex care plans, member status, outcomes, treatment side effects, complications, and clinical symptoms
Review member data to identify health risks and care gaps and recommend improvements
Collaborate with healthcare providers regarding complex cases and revised care plans
Collect, document, and maintain member information and care management activities
Provide training and education to care management teams and providers
Partner with leadership to improve cost-effective care and quality delivery
Monitor compliance with corporate, state, and NCQA standards
Work with senior management on escalated cases and guide junior team members
Review reports, monitor quality and productivity metrics, manage case assignments, and audit staff
Perform other duties as assigned and comply with all policies and standards

Requirements

What you’ll need

Must reside in North Carolina
Master's degree in Behavioral Health or Social Work, or a degree from an accredited school of nursing
5–7 years of related experience
Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements, with behavioral health experience required
Pediatric experience highly desired
Ability to oversee complex behavioral health and social-needs care plans
Knowledge of state and federal regulations, third-party payer requirements, and NCQA standards
Approximately 10% travel may be required for occasional meetings or team events in Raleigh or Charlotte
For Illinois Youth Care plan: must reside in Illinois and hold a graduate degree plus independent behavioral health licensure, or a bachelor's degree and IL RN licensure
For Sunshine Health (FL): must hold a master's degree in social work or related field, one year of related professional pediatric care experience, and an LCSW, LMHC, or other Clinical Mental Health Professional license; may require up to 80% local travel

Benefits

Comp & perks

Health insurance
401K plan
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation