Pediatric Care Manager, Social Work
Company: Sunshine State Health Plan
Posted on: November 18, 2023
You could be the one who changes everything for our 28 million
members as a clinical professional on our Medical Management/Health
Services team. Centene is a diversified, national organization
offering competitive benefits including a fresh perspective on
This is a remote/work-from-home position where member visits are
required. Candidates must reside in the Miami-Dade County region to
be considered for this role.
Position Purpose: 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.
Develop, assess and adjust, as necessary, the care plan and promote
Assess 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 assessment with specific
objectives, goals and interventions designed to meet member's
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
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 assessments, 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
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.
Licensure requirement: Master's degree in Social Work and LCSW,
Experience: 1 year (minimum) pediatric experience
Location: Residency required 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, sex, sexual orientation,
gender identity, national origin, disability, veteran status, or
other characteristic protected by applicable law.
Keywords: Sunshine State Health Plan, Miami , Pediatric Care Manager, Social Work, Executive , Miami, Florida
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