Care Manager
 Spectraforce Technologies | |||||||
remote work
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 United States, Florida, Alachua | |||||||
 Apr 12, 2025 | |||||||
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Title: Care Manager (RN) Duration: 03 Months - Contract to Hire Location: Remote FL (Member Facing) - Remote - Making face-to-face visits at members' homes or at another agreed-upon location. Highest need Citrus then Putnam, Lake, Marion, Alachua 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 - this may vary based on caseload Monday - Friday 8-5 EST Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high-quality, cost-effective healthcare outcomes, including personalized care plans and education for members and their families related to mental health and substance use disorder. Education/Experience: 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 experience. License/Certification: Licensed Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, LPC and RN with BH experience required For Illinois Youth Care Contract: Master's degree in social sciences, social work, or related field required 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: Pediatrics - Minimum of 2 years Nice to haves: Bilingual Spanish/English preferred, Experience with electronic medical records, Basic Excel skills
Position is offered by a no fee agency. | |||||||