Care Manager

Davita Inc.; Miami (FL); Remote; USD 60,000 - 75,000; Full time

Job summary

A leading healthcare organization is seeking a Care Manager (RN) for a 3-month contract to hire position, focused on developing care plans and coordinating services for pediatric members. The role requires strong assessment skills, a nursing degree, and a minimum of 2 years pediatric experience, as well as proficiency in Excel. This position operates remotely and requires a commitment to providing exceptional care and support to members and their families.

Qualifications

• Requires 2 - 4 years of related experience, preferably in Pediatrics.
• Must possess an active LCSW/LMHC license in Florida.
• Bilingual skills preferred.

Responsibilities

• Perform care management duties to assess, plan and coordinate services.
• Coordinate care by finding providers and assisting with authorization.
• Conduct daily outreach calls for member check-ins.

Skills

Pediatrics

Microsoft Excel

Computer Savvy

Bilingual

Education

Degree from an Accredited School of Nursing

Job description

Title: Care Manager (RN)

Duration: 03 Months - Contract to Hire

Location: Remote FL (Member Facing) - Candidate must reside within region 11 - Miami Dade; Monroe

Face to face visits, Caseload based travel (80%/30%), Max 50 mile radius

Leadership works to have the new hire work within a 50-mile radius - may vary based on caseload

Monday - Friday 8-5 EST



Position Purpose:

Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families.



Responsibilities:

• Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.


• Coordinate care (finding providers)


• Assisting in authorization


• Creating assessments and care plans


• Required to complete daily outreach calls based on member specific tiers


• Based on members needs the call volume will vary 5-20 calls per day


• Contractual obligation is a weighted 200 caseload


• Tier 3 - 2.2


• Tier 4 - 1


• Outreach calls are to check in on the members, follow up on their needs, remove any barriers to care for the members.


• Ensuring that the children's needs are met (having issues at school, having a home health aide to assist)


• Leadership will complete chart and call audits on a monthly basis or as needed.


• Documentation is key

Education/Experience:

Requires a Degree from an Accredited School of Nursing or a bachelor's degree in nursing and 2 - 4 years of related experience.

Candidate Requirements
Education/Certification	Required: Social Work- LCSW/LMHC license active in Florida	Preferred: N/A
Licensure	Required: N/A	Preferred: N/A
Years of experience required Disqualifiers Best vs. average Performance indicators	Must haves: 2 years' Peds experience Nice to haves: Bilingual preferred BH high plus because of diagnosis needed in some cases Experience with electronic medical records Basic Excel skills Disqualifiers: Performance indicators: Case by case for metrics: performance based, expected high documentation of calls Best vs. average:
Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection	1	Pediatrics - Minimum of 2 years
2	Microsoft - Excel (must be able to use filtering)
3	Computer Savvy

Position is offered by a no fee agency.