Pediatric Program Specialist, Social Work

Company: Sunshine State Health Plan
Location: West Palm Beach
Posted on: November 20, 2023

Job Description:

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 workplace flexibility.


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: Conduct screening and risk assessment interventions per program guidelines. Act as primary liaison for members and staff. Assist with aspects of the member's care, including referrals to community resources.

Identify special needs members through the completion of health screens and other resources
Work with community outreach/member advocates to coordinate member care
Educate providers and community resources on program components and available support services
Educate members with special needs to foster compliance with program and positively impact outcomes
Conduct site visits as appropriate for programs and provide support to other special programs
Develop and modify care plans in conjunction with member, member's family and managing physician
Development of plan specific literature and education materials in conjunction with medical director and corporate oversight

Education/Experience: Bachelor's degree in Social Work, Nursing, Health, Behavioral Science or equivalent experience. Master's degree in Social Work preferred. 4+ years of community experience in directly managing and integrating the social/community needs of the members. Experience in a managed care environment or working with people with disabilities and vulnerable populations who have chronic and complex conditions.

License/Certification: Valid driver's license, except not required for Indiana. RN (Registered Nurse), LCSW (Licensed Certified Social Worker), LPN (Licensed Practical Nurse), Occupational Therapy (OT), Physical Therapy (PT), or LVN (Licensed Vocational Nurse) preferred.

For Sunshine Health (FL): Employees supporting Florida's Children's Medical Services (CMS) must be a Florida licensed registered nurse with a minimum of two years of pediatric experience, Florida licensed practical nurse with a minimum of four years of pediatric experience, or a Master's degree in social work with a minimum of one year of related professional pediatric care experience. May require up to 80% local travel.

Additional Details:

Licensure requirement: Valid driver's license


Experience: Master's degree in social work with a minimum of one year of related professional pediatric care 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, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Keywords: Sunshine State Health Plan, Miami , Pediatric Program Specialist, Social Work, Healthcare , West Palm Beach, Florida