Location: Miami Gardens, FL
Company: Sunshine State Health Plan
required. Candidates must reside in Miami-Dade County to be considered for this role. Position Purpose: Perform care management duties to backss, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
Develop, backss and adjust, as necessary, the care plan and promote desired outcome backss the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to
meet the complete medical socio economic needs of clients Develop plan of care based upon backssment with specific objectives, goals and interventions designed to meet member's needs Provide patient and provider education Facilitate member access to community based services Monitor referrals made to community based organizations, medical care and other services to support the members overall care management plan Actively participate in integrated team care management rounds Identify related risk management quality concerns and report these scenarios to the appropriate resources Enter and maintain backssments, authorizations, and pertinent clinical information into various medical management systems
Education/Experience: Bachelor s degree in Social Work.
2+ years of social work experience in an acute care or community setting. Knowledge of government sponsored managed care programs preferred. Licenses/Certifications: Current state s LMSW or LCSW license. For Sunshine Health (FL): An RN, LCSW, LMSW, LMHC or other Mental Health Professional license is required. Employees supporting Florida's Children s Medical Services (CMS) must have one of the above professional licenses and 1. Minimum of two years of pediatric experience for Florida licensed registered nurses, or 2. 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. Additional Details: Licensure requirement: Master s degree in social work or related field, Florida LMSW or LMHC, and have one year of related professional pediatric care experience Experience: 1 year (minimum) pediatric experience Location: Candidates must reside in Miami-Dade County Travel: 80% local travel Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
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, interaction, interactionual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Associated topics: adhd, child, children, kid, md do, neonatology, ped, pediatric, primary, primary care
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Management & Executive Jobs encompass a range of high-level positions within organizations, typically involving the responsibility for strategic planning, decision-making, and leading teams or entire departments. Individuals in these roles are expected to possess strong leadership skills, the ability to think critically and strategically, as well as excellent communication abilities. Executives often have a significant influence on company culture, operations, and financial success. These roles include titles such as CEO, CFO, COO, Managing Director, as well as various managerial positions across different departments such as sales, marketing, human resources, and more.
