Care Manager
 Spectraforce Technologies | |||
remote work
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 United States, Florida, Miami | |||
 Apr 12, 2025 | |||
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Title: Care Manager
Location: Remote- Region 11- North Miami Prefer Miami/ Dade 80% work from home /Travel is based on caseload (30%) Duration: 3 Months (Potential to Extend/Convert) Shift: 8-5 M-F, no OT Must haves: Pediatric experience of 2 years minimum 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 Nice to haves: Bilingual preferred BH high plus because of diagnosis needed in some cases Experience with electronic medical records Basic Excel skills
Position is offered by a no fee agency. | |||