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Pediatric Care Manager (Social Work)
Centene - Miami, FL
posted 2 months ago
About the position
The Pediatric Care Manager (Social Work) at Sunshine State Health Plan 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 requires local travel for member visits and is designed for candidates residing in specific counties in Florida.
Responsibilities
- Develops and facilitates complex care management activities for members with mental and behavioral health needs.
- Evaluates member needs via phone or in-home visits and recommends care/service plans.
- Performs outreach to assess member needs and collaborates with resources.
- Develops ongoing care plans for members with high acuity and identifies necessary providers and community resources.
- Coordinates between members, families, community resources, and care provider teams to ensure service accessibility.
- Monitors care plans and member status, providing recommendations based on identified needs.
- Facilitates care coordination with appropriate providers to ensure timely access to services.
- Documents and maintains member information and care management activities for compliance.
- Educates members and families on healthcare procedures, treatment options, and benefits.
- Provides feedback to leadership on opportunities to improve care delivery.
Requirements
- Master's degree in Behavioral Health or Social Work.
- 2 - 4 years of related experience in pediatric care management.
- Licensed Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) as per state contract requirements.
- Minimum of two years of pediatric experience for employees supporting Florida's Children's Medical Services.
Nice-to-haves
- Bilingual candidates preferred.
Benefits
- Competitive pay
- Health insurance
- 401K and stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible work schedules including remote, hybrid, field, or office work options.
