Care Manager Job at Sunshine State Health Plan, Florida

WWJUMGtHaTA1Qk9xaFVOL1pmQ1JsOUpTZ3c9PQ==
  • Sunshine State Health Plan
  • Florida

Job Description

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.

**Qualified candidates must be based in Hardee, Highlands, Hillsborough, Manatee or Polk counties in the s tate of Florida. This position involves travel for fieldwork, including in-home visits.**

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 or a Degree from an Accredited School of Nursing and 2 – 4 years of related experience.

License/Certification:

Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN 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

Job Tags

Holiday work, Full time, Contract work, Local area, Remote job, Flexible hours,

Similar Jobs

HRU Tech

Automotive Mechanic Job at HRU Tech

 ...environment. Work Schedule & Compensation ~**Hours: **2nd Shift - 2:00pm-10:00pm ~ Compensation: $28.00/hr Equal Opportunity Employer EOE (including Disability/Veterans). You should be proficient in: ~ Automotive Repair Salary info: $28 - $28 / hr... 

KPM LAW (Kalbaugh Pfund & Messersmith, P.C.)

Part-Time Remote/Hybrid Attorney - Workers' Compensation Claims (Virginia) Job at KPM LAW (Kalbaugh Pfund & Messersmith, P.C.)

 ...Strong written and verbal communication skills. Ability to work independently and manage tasks in a timely manner in a remote or...  ...with excellent organizational skills. Why Join Us? Work from home or a hybrid model for flexibility and work-life balance. Opportunity... 

Reverba Global

Patient Outreach Representative Job at Reverba Global

 ...this job. Position Type/Expected Hours of Work This is a full-time position. Benefits/Perks Medical, Dental, Vision, HSA, FSA, STD, LTD, Life Insurance, Supplemental Insurance, EAP, Pet Insurance, 401(k), Paid Time Off, Holidays, Sick pay, internet allowance,... 

East West Bank

Senior Relationship Manager - Private Equity Job at East West Bank

 ...and create new opportunities, and our sustained growth and expertise in industries like real estate, entertainment and media, private equity and venture capital, and high-tech help build sustainable businesses and expand our associates potential for career advancement... 

K.A. Recruiting, Inc.

Medical Laboratory Technician (MLT) OR Medical Laboratory Scientist/Medical Technologist (MLS/MT) Job at K.A. Recruiting, Inc.

*SIGN ON BONUS AND/OR RELOCATION ASSISTANCE AND QUICK INTERVIEW PROCESS* Job Summary: Under the direction of the laboratory manager and designated supervisory staff, the medical technologist provides routine and specialized laboratory testing in a timely manner for patient...