Miami, Florida

Position Purpose: Oversees the care for long term support services / long term care populations and provides coordination of care services for lower acuity individuals living in the community or nursing facilities. Ensures a comprehensive assessment of member's care needs and status, interdisciplinary team approach, and education of members. Works closely with internal and external partners to achieve optimal health care outcomes for the member through effective coordination of care activities.

  • Coordination and care management of members with lower utilization of home community services (i.e. members attending adult day care services or those who are stable on current medication / treatment regimens).
  • Manages an active caseload based on state mandated ratios according to residential setting, case intensity and acuity.
  • Ensures comprehensive assessments are completed within required time frames and utilizes knowledge and expertise to assess options for care including use of benefits and community resources.
  • Partners effectively with the PCP, Specialist, member, member’s family and integrated care teams (ICT) to develop a Person Centered Care Plan.
  • In partnership with the member, family, physician(s), ICT and other providers, assesses short and long term member needs, evaluates the need for alternative services and establishes member driven care management objectives.
  • Responsible for coordination of service authorizations (i.e. meals, transportation, activities of daily living).
  • Educates on and coordinates community resources with emphasis on medical, behavioral and social services. Applies care management standards and maintains HIPAA standards and confidentiality of protected health information.
  • Ensures compliance with all state and federal regulations and guidelines in day-to-day activities.
  • Performs special projects as assigned.Additional Responsibilities:

Education/Experience: Bachelor's degree in social work, sociology, psychology, gerontology, or other related social services field and 2+ years of relevant experience OR Master's degree in social work, sociology, psychology, gerontology, or a related social services field, 1+ years of experience obtained through a practicum, internship, or clinical rotation on an equivalent basis and 1+ years of relevant experience OR Equivalent experience of 6+ years. (Florida LTC and Illinois LTSS) Applicants must reside in either southern half of Miami-Dade County or Monroe County, FL in/near areas like Kendall, Doral, West Kendal, Cutler Bay, Homestead, or Florida Keys (Key Largo, Tavernier, Islamorada, Layton, Duck Key, Marathon, Big Pine Key, Key West). Professional fluency in Spanish AND English is strongly preferred due to majority Spanish-speaking caseload. This position is work-from-home with field visits that are indefinitely suspended due to COVID-19.

Licenses and Certifications: CPR Certified (Florida Only), Certified Case Manager (CCM) preferred.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Miami, Florida

Centene Corporation, a Fortune 500 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on under-insured and uninsured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). The Company operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services.

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