(High Salary) Pediatric Care Manager (Social Worker) Position Available In Miami-Dade, Florida

Job Description:

You could be the one who changes everything for our 28 millionmembers. Centene is transforming the health of our communities, oneperson at a time. As a diversified, national organization, you’llhave access to competitive benefits including a fresh perspectiveon workplace flexibility. This position is remote and field basedwith local travel required for member visits. Candidates mustreside in one of the following counties in Florida to beconsidered: Escambia, Santa Rosa, Okaloosa, or Walton. 1 year(minimum) of pediatric experience is required.

Position Purpose:

Develops, assesses, and facilitates complex care managementactivities for primarily mental and behavioral health needs membersto provide high quality, cost-effective healthcare outcomesincluding personalized care plans and education for members andtheir families related to mental health and substance use disorder

• Evaluates the needs of the member via phone or in-home visitsrelated to the resources available, and recommends and/orfacilitates the care plan/service plan for the best outcome, whichmay include behavioral health and social determinant needs
• Mayperform telephonic, digital, home and/or other site visits outreachto assess member needs and collaborate with resources
• Developsongoing care plans for members with high level acuity and works toidentify providers, specialists, and community resources needed forcare including mental health and substance use disorders
• Coordinates as appropriate between the member and/orfamily/caregivers, community resources, and the care provider teamto ensure identified services are accessible to members
• Monitorscare plans/service plans and/or member status and outcomes forchanges in treatment side effects, complications and clinicalsymptoms and provides recommendations to care plan/service planbased on identified member needs
• Facilitates care coordinationand collaborates with appropriate providers or specialists toensure member has timely access to needed care or services
• Collects, documents, and maintains member information and caremanagement activities to ensure compliance with current state,federal, and third-party payer regulators
• Provides education tomembers and their families on procedures, healthcare providerinstructions, treatment options, referrals, and healthcarebenefits, which may include behavioral health and socialdeterminant needs
• Provides feedback to leadership onopportunities to improve and enhance care and quality delivery formembers in a cost-effective manner
• Performs other duties asassigned.
• Complies with all policies and standards.

Education/Experience:

Requires a Master’s degree in BehavioralHealth or Social Work and 2

• 4 years of related experience.

License/Certification:

• Licensed Master’s Behavioral HealthProfessional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) based on statecontract requirements with BH experience required
• For SunshineHealth (FL)

Only:

Employees supporting Florida’s Children’s MedicalServices must Hold a Master’s degree in social work or relatedfield and have one year of related professional pediatric careexperience. May require up to 80% local travel required

Pay Range:

$55,100.00

• $99,000.

00 per year Centene offers a comprehensivebenefits package including: competitive pay, health insurance, 401Kand stock purchase plans, tuition reimbursement, paid time off plusholidays, and a flexible approach to work with remote, hybrid,field or office work schedules. Actual pay will be adjusted basedon an individual’s skills, experience, education, and otherjob-related factors permitted by law. Total compensation may alsoinclude additional forms of incentives. Centene is an equalopportunity employer that is committed to diversity, and values theways in which we are different. All qualified applicants willreceive consideration for employment without regard to race, color,religion, sex, sexual orientation, gender identity, nationalorigin, disability, veteran status, or other characteristicprotected by applicable law. Qualified applicants with arrest orconviction records will be considered in accordance with the LACounty Ordinance and the California Fair Chance Act