Pediatric Care Manager (Social Worker)

Sunshine Health; Orlando (FL); Remote; USD 55,000 - 99,000; Full time

Job summary

Sunshine Health is seeking a Pediatric Care Manager (Social Worker) to enhance care for members with mental and behavioral health needs. This remote role involves developing care plans, coordinating with providers, and ensuring members access necessary resources. Applicants should hold a Master's degree in Social Work or related field with at least one year of pediatric experience and reside in specified Florida counties.

Benefits

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules

Qualifications

• Requires a Master's degree in Behavioral Health or Social Work.
• 2-4 years of related experience required.
• Licensed Behavioral Health Professional in the state.

Responsibilities

• Develops and facilitates care management for mental and behavioral health needs.
• Evaluates member needs and coordinates care plans.
• Monitors care plans for changes in treatment or symptoms.

Skills

Care coordination

Mental health knowledge

Communication

Education

Master's degree in Behavioral Health or Social Work

Job description

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You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

• This position is remote and field based with local travel required for member visits. Candidates must reside in one of the following counties in Florida to be considered Escambia, Santa Rosa, Okaloosa, or Walton. 1 year (minimum) of pediatric experience is required.***
  
  

Position Purpose Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substance use disorder.

• 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.
  
  

Education/Experience Requires a Master's degree in Behavioral Health or Social Work and 2 – 4 years of related experience.

License/Certification

• Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) based on state contract requirements with BH experience required
• For Sunshine Health (FL) Only Employees supporting Florida's Children’s Medical Services must Hold a Master’s degree in social work or related field and have one year of related professional pediatric care experience. May require up to 80% local travel required
  
  

Pay Range $55,100.00 - $99,000.00 per year

Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care and Insurance

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