Pediatric Care Manager, Social Work
$54,000 - $97,100/Yr
Centene - Kissimmee, FL
posted 2 months ago
Full-time - Mid Level
Remote - Kissimmee, FL
Ambulatory Health Care Services
About the position
The Pediatric Care Manager is responsible for developing, assessing, and facilitating complex care management activities primarily focused on mental and behavioral health needs for members. This role aims to provide high-quality, cost-effective healthcare outcomes through personalized care plans and education for members and their families. The position involves evaluating member needs, coordinating care, and ensuring access to necessary services, while also monitoring treatment outcomes and compliance with regulations.
Responsibilities
- Develop and assess complex care management activities for mental and behavioral health needs.
- Evaluate member needs via phone or in-home visits and recommend care/service plans.
- Develop ongoing care plans for members with high acuity and identify necessary providers and resources.
- Coordinate between members, families, community resources, and care provider teams.
- Monitor care plans and member status for changes in treatment and provide recommendations.
- Facilitate care coordination with providers to ensure timely access to services.
- Document and maintain member information and care management activities for compliance.
- Educate members and families on healthcare procedures, treatment options, and benefits.
- Provide feedback to leadership on opportunities to improve care delivery.
Requirements
- Master's degree in Behavioral Health or Social Work required.
- 2 - 4 years of related experience in pediatric care management.
- Licensed Behavioral Health Professional (LCSW, LMSW, LMFT, LMHC, LPC) required.
Nice-to-haves
- Bilingual preferred.
- Experience in pediatrics is a plus.
Benefits
- 401(k)
- Health insurance
- Paid holidays
- Paid time off
- Tuition reimbursement
