Pediatric Care Manager (Social Work)-Remote Available

Company: Sunshine State Health Plan
Location: Kathleen
Posted on: January 13, 2022

Job Description:

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, youll have access to competitive benefits including a fresh perspective on workplace flexibility.Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.

• Develop, assess and adjust, as necessary, the care plan and promote desired outcome
• Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
• Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
• Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
• Provide patient and provider education
• Facilitate member access to community based services
• Monitor referrals made to community based organizations, medical care and other services to support the members overall care management plan
• Actively participate in integrated team care management rounds
• Identify related risk management quality concerns and report these scenarios to the appropriate resources
• Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
• For Michigan Complete Health - home visits requiredAdditional Details:*Department: Children's Medical Services*Caseload: Pediatrics - Newborn to 21-year olds. Caseload based on residence.*Territory: Polk County (Davenport or Haines City, FL area). Work-from-home case management role with indefinitely suspended home visits due to COVID-19. Field/Local travel typically within county. Must reside in or be willing to relocate to the above mentioned area of Florida. Travel will be 70% once we return again to member home visits.Our Comprehensive Benefits Package:
  • Flexible work solutions including remote options, hybrid work schedules and dress flexibility
  • Competitive pay
  • Paid Time Off including paid holidays
  • Health insurance coverage for you and dependents
  • 401(k) and stock purchase plans
  • Tuition reimbursement and best-in-class training and developmentEducation/Experience: For Sunshine Health (FL): An RN, LCSW, LMSW, LMHC or other Mental Health Professional license is required.Employees supporting Florida's Childrens Medical Services (CMS) must have one of the above professional licenses and 1. Minimum of two years of pediatric experience for Florida licensed registered nurses, or 2. Hold a Masters degree in social work and have one year of related professional pediatric care experience.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.

Keywords: Sunshine State Health Plan, Lakeland , Pediatric Care Manager (Social Work)-Remote Available, Executive , Kathleen, Florida