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 / work-from-home with local travel required for member visits. Candidates must reside in Orange, Osceola, or Seminole Counties in Florida to be considered for this role.
2 years of pediatric experience required. Bilingual preferred.
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 Behavioral Health Professional based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, LPC with BH experience required
For Sunshine Health (FL) Only : Employees supporting Florida's Children’s Medical Services (CMS) must have a minimum of two years of pediatric experience
Pay Range : $54,000.00 - $97,100.00 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
Pediatric Care Manager, Social Work
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 subs...
Waiver Support Coordinator/Social Work Case Manager
Bachelor's degree required and at least two years experience working with developmental disabilities, mental health, special education, or social work. On-site office work and off-site work visiting clients in different locations. ...
Pediatric Care Manager (RN)
Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits. Develops, assesses, and facilitates complex care management activities for primarily physical ...
Associate Nurse Manager, Pediatric Intensive Care Unit , Full Time, Nights
Strategic Vision: The Associate Nurse Manager works closely with the Nurse Manager and nursing leadership team to understand and support the mission, vision, values and strategic initiatives of Jackson Health System and demonstrates a commitment to quality service to patients, physicians, the public...
Pediatric Care Manager, RN (ECC)
Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits. Develops, assesses, and facilitates complex care management activities for primarily physical ...
Social Work Case Manager, Case Management, FT, 1P-9:30P
Ability to work with multiple members of a care team and maintain positive working relationships Minimum Required Experience: 1. Baptist Health South Florida is the region’s largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpat...
Gig Work Mentor - Social Media Manager
Fud, the World's First Social Hustling Community, is seeking a Gig Work Mentor - Social Media Manager to join our team. As a Gig Work Mentor, you will play a vital role in supporting and mentoring individuals who are interested in pursuing gig work and side hustles. Stay up-to-date with the latest t...
Social Work Case Manager (US)
The Social Work Case Manager is responsible for ensuring effective psychosocial intervention, positively impacting a patient's ability to manage his/her chronic illness. Manages behavioral and psychosocial needs that result in improved clinical and financial outcomes and delivers social work interve...
Social Work Case Manager, Case Management, Per Diem, 8:30A-5P
Ability to work with multiple members of a care team and maintain positive working relationships. Baptist Health South Florida is the region’s largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpatient centers, urgent care facil...
Social Work Case Manager, Case Management, FT, 8A-6:30P
Ability to work with multiple members of a care team and maintain positive working relationships Minimum Required Experience: 1. Baptist Health South Florida is the region’s largest not-for-profit healthcare organization with 12 hospitals, more than 27,000 employees, 4,000 physicians, and 200 outpat...