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Pediatric Care Manager (Social Work)
$54,000 - $97,100/Yr
Centene - West Palm Beach, FL
posted 2 months ago
Full-time - Mid Level
Remote - West Palm Beach, FL
Ambulatory Health Care Services
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, particularly in relation to mental health and substance use disorders.
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 for optimal outcomes.
- Performs outreach to assess member needs and collaborates with resources for care coordination.
- Develops ongoing care plans for members with high acuity and identifies necessary providers and community resources.
- Monitors care plans and member status for changes in treatment and provides recommendations based on identified needs.
- Facilitates care coordination and ensures timely access to needed services for members.
- Documents and maintains member information and care management activities for compliance with regulations.
- Educates members and their families on healthcare procedures, treatment options, and benefits.
- Provides feedback to leadership on opportunities to improve care delivery and quality.
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 (e.g., LCSW, LMSW, LMFT, LMHC, LPC) as per state contract requirements.
Nice-to-haves
- Bilingual candidates preferred.
- Experience in telephonic and digital outreach for care management.
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
