New

Care Manager

Spectraforce Technologies

remote work

United States, Florida, Miami

Apr 12, 2025

Title: Care Manager

Duration: 03 Months - Contract to Hire

Location: Remote FL (Member Facing) - Candidate must reside within region 11 - Miami Dade; Monroe

Member Facing Face to face visits 80% work from home /Travel is based on caseload (30%)

Leadership works to have the new hire work within a 50-mile radius - may vary based on caseload

Monday - Friday 8-5 EST

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

Must haves:

2 years' Peds experience

Nice to haves:

Bilingual preferred
BH high plus because of diagnosis needed in some cases
Experience with electronic medical records
Basic Excel skills

Candidate Requirements
Required: Social Work- LCSW/LMHC license active in Florida	Preferred: N/A
Required: N/A	Preferred: N/A

Position is offered by a no fee agency.