Care Manager

Spectraforce Technologies; Green Cove Springs (FL); Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a dedicated Care Manager to coordinate care for special needs families. This role involves evaluating member needs through virtual and in-person visits, developing care plans, and collaborating with providers to ensure timely access to services. The ideal candidate will possess a Master's Degree and an active LCSW/LMHC license in Florida, with at least two years of experience in Pediatrics. Join a forward-thinking organization that values innovative approaches to healthcare and offers a flexible remote work environment with occasional field visits.

Qualifications

• Minimum of 2 years experience in Pediatrics required.
• Must have LCSW/LMHC license active in Florida.

Responsibilities

• Coordinate care for special needs families on the CMS plan.
• Evaluate member needs via phone or in-home visits.

Skills

Pediatrics

Problem solving

Resource providing

Bilingual Spanish/English

Basic Excel skills

Education

Master's Degree

Tools

Microsoft Office

Electronic Medical Records (EMR)

Job description

Title: Care Manager

Duration: 3 Months (Potential to extend/convert FTE)

Location: Remote - Face-to-face visits at members' homes/other agreed-upon public locale. Highest need Clay, Duval, Volusia

Mon-Fri 8A-5P



Job Description:

• COORDINATING CARE FOR SPECIAL NEEDS FAMILY ON THE CMS PLAN


• Set tasking of assigned caseload Max 200 members


• Virtual with a couple of in person meetings per year


• Remote/Autonomous high tech work environment with field visits and telephone contact of members


• Combination of Tier 3&4 (A good mix of both, but majority of Tier 4)


• Evaluates the needs of the member via phone or in-home visits related to the resources available, and recommends and/or facilitates the care plan/service plan for the best outcome, which may include behavioral health and social determinant needs


• May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources


• Develops ongoing care plans for members with high level acuity and works to identify providers, specialists, and community resources needed for care including mental health and substance use disorders


• Coordinates as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members


• Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs


• Facilitates care coordination and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services


• Collects, documents, and maintains member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators


• Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs


• Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner


• Performs other duties as assigned


• Complies with all policies and standards

Candidate Requirements
Education/Certification	Required: Master's Degree	Preferred: none
Licensure	Required: LCSW/LMHC license active in Florida	Preferred: None
Years of experience required Disqualifiers Best vs. average Performance indicators	Must haves: Pediatrics - Minimum of 2 years Nice to haves: Bilingual Spanish/English preferred, Experience with electronic medical records, Basic Excel skills; medical background (hospital setting) Disqualifiers: Non licensure Performance indicators: Caseload compliance Best vs. average:
Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection	1	Technology including Microsoft and EMR
2	Problem solving
3	Resource providing

Position is offered by a no fee agency.