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Pediatric Care Manager (Social Work)
Centene - Hialeah, 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
- 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.
- 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, providing recommendations based on identified needs.
- Facilitate care coordination and collaborate with providers to ensure timely access to services.
- Collect, document, and maintain member information to ensure compliance with regulations.
- Educate members and families on healthcare procedures, treatment options, and benefits.
- Provide feedback to leadership on opportunities to improve care delivery.
- Perform other duties as assigned.
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) with behavioral health experience.
Nice-to-haves
- Bilingual in English and Spanish 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.
