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Pediatric Care Manager, Social Work
Centene - Kissimmee, FL
posted 2 months ago
About the position
The Pediatric Care Manager in Social Work 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 facilitate complex care management activities for members with mental and behavioral health needs.
- Evaluate member needs via phone or in-home visits and recommend care/service plans.
- Perform outreach through telephonic, digital, and home visits to assess member needs.
- Develop ongoing care plans for members with high acuity and identify necessary providers and community resources.
- Coordinate between members, families, community resources, and care provider teams to ensure service accessibility.
- Monitor care plans and member status for changes in treatment and provide recommendations based on identified needs.
- Facilitate care coordination with appropriate providers to ensure timely access to services.
- Document and maintain member information and care management activities for compliance with regulations.
- 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.
- 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.
Nice-to-haves
- Bilingual candidates preferred.
- Experience in telehealth or digital health services.
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.
