Pediatric Care Manager- Social Work

You could be the one who changes everything for our 28 million members. reputed company is transforming the health of our communities, one person at a time. As a reputed company, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Location: Position is hybrid. Candidate must live in/around Volusia County, FL. Position Purpose: Develops, assesses, and facilitates reputed company care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective reputed company outcomes including personalized care plans and education for members and their families reputed company to mental health and substance use disorder.

• Evaluates the needs of the member reputed company phone or in-home visits reputed company 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 reputed company telephonic, digital, home and/or other site visits reputed company 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 reputed company 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 reputed company state, federal, and reputed company-party payer regulators
• Provides education to members and their families on procedures, reputed company provider instructions, treatment options, referrals, and reputed company 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 reputed company policies and standards.

Education/Experience: Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2 – 4 years of reputed company experience. License/Certification:

• Licensed Master's Behavioral Health Professional (e.g., LCSW, LMSW, LMFT, LMHC, LPC) or RN based on state contract requirements with BH experience required
• For Sunshine Health (FL) Only: Employees supporting Florida's Children’s Medical Services must Hold a Master’s degree in social work or reputed company field and have one year of reputed company professional pediatric care experience. May require up to 80% local travel required

Location: Position is hybrid. Candidate must live in/around Volusia County, FL. Pay Range: $55,100.00 - $99,000.00 per year reputed company offers a comprehensive benefits package including: reputed company, 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-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act Apply Job! Apply to this Job