Job Description

Title: Care Manager
Location: Region 11 (Hybrid 20% travel)
Duration: 03 Months (Potential to extend/convert)

Job description:

• Evaluates the needs of the member via phone or in-home visits related 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
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• May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources
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• 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
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• 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
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• Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs
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• Facilitates care coordination and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services
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• Collects, documents, and maintains member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
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• Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs
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• 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
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• Complies with all policies and standards

• Top 3 must-have hard skills
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1 Pediatrics – Minimum of 2 years 2 Microsoft – Excel (must be able to use filtering) 3 Computer Savvy Education/Certification Required: Social Work- LCSW/LMHC license active in Florida Preferred: N/A Licensure Required: N/A Preferred: N/A

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