LCSW, LMHC - Pediatric Care Manager II (Social Work) -- Remote Available

Fidelis Care

St. Louis Missouri

United States

Healthcare - Physician
(No Timezone Provided)

You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

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
  • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
  • 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
  • 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.
  • Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • Direct care to participating network providers
  • Perform duties independently, demonstrating advanced understanding of complex care management principles.
  • Participate in case management committees and work on special projects related to case management as needed.
  • Additional Details:
    *Department: Children's Medical Services
    *Caseload: Pediatrics - Newborn to 21-year olds. Caseload based on residence.
    *Territory: Orange County (Orlando, Apopka, Winter Park, FL area). Work-from-home case management role with indefinitely suspended home visits due to COVID-19. Field/Local travel typically within county. Must reside in or be willing to relocate to the above mentioned area of Florida. Travel will be 70% once we return again to member home visits.


    Our Comprehensive Benefits Package:

  • Flexible work solutions including remote options, hybrid work schedules and dress flexibility
  • Competitive pay
  • Paid Time Off including paid holidays
  • Health insurance coverage for you and dependents
  • 401(k) and stock purchase plans
  • Tuition reimbursement and best-in-class training and development
  • Education/Experience:

    For Sunshine Health: 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 and have one year of related professional pediatric care experience.

    LCSW, LMHC - Pediatric Care Manager II (Social Work) -- Remote Available

    Fidelis Care

    St. Louis Missouri

    United States

    Healthcare - Physician

    (No Timezone Provided)

    You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
     

    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
  • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
  • 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
  • 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.
  • Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • Direct care to participating network providers
  • Perform duties independently, demonstrating advanced understanding of complex care management principles.
  • Participate in case management committees and work on special projects related to case management as needed.
  • Additional Details:
    *Department: Children's Medical Services
    *Caseload: Pediatrics - Newborn to 21-year olds. Caseload based on residence.
    *Territory: Orange County (Orlando, Apopka, Winter Park, FL area). Work-from-home case management role with indefinitely suspended home visits due to COVID-19. Field/Local travel typically within county. Must reside in or be willing to relocate to the above mentioned area of Florida. Travel will be 70% once we return again to member home visits.


    Our Comprehensive Benefits Package:

  • Flexible work solutions including remote options, hybrid work schedules and dress flexibility
  • Competitive pay
  • Paid Time Off including paid holidays
  • Health insurance coverage for you and dependents
  • 401(k) and stock purchase plans
  • Tuition reimbursement and best-in-class training and development
  • Education/Experience:

    For Sunshine Health: 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 and have one year of related professional pediatric care experience.