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Care Manager I - Orlando, United States - Centene Corporation
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.
HIRING STATEWIDE
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.
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 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 assessments, authorizations, and pertinent clinical information into various medical management systems
For Sunshine Health Plan may require up to 80% local travel
Performs other duties as assigned
Complies with all policies and standards
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.Pay Range:
$54,000 - $97,100 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.
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