Pediatric Care Manager Behavioral Health
| Company | Centene |
|---|---|
| Location | Orlando, FL, USA, Kissimmee, FL, USA |
| Salary | $55100 – $99000 |
| Type | Full-Time |
| Degrees | Master’s |
| Experience Level | Mid Level, Senior |
Requirements
- 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 related pediatric experience.
- Licensed Behavioral Health Professional based on state contract requirements e.g., LCSW, LMFT, LMHC
- Candidates must reside in Orange, Osceola, Brevard or Seminole County for face to face visits with members.
Responsibilities
- 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.
- May perform telephonic, digital, home and/or other site visits outreach 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 side 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 current state, federal, and third-party payer regulators.
- 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.
- 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 all policies and standards.
Preferred Qualifications
-
No preferred qualifications provided.