We have a meaningful opportunity for you to make a difference in the lives of our 28 million members by joining our Medical Management/Health Services team as a clinical professional. Centene is a national organization that values workplace flexibility and offers competitive benefits.

This is a remote/work-from-home position that requires member visits. To be considered for this role, candidates must reside in the Miami-Dade County region.

Job Purpose: As a care management professional, you will assess, plan, and coordinate all aspects of medical and supporting services for select members. Your goal is to promote quality and cost-effective care.

• Develop, assess, and adjust care plans to achieve desired outcomes
• Evaluate the member's current health status, treatment plan, prognosis, and goals
• Coordinate services between primary care physicians, specialists, and non-medical staff to meet the needs of clients
• Create a care plan with specific objectives, goals, and interventions
• Provide education to patients and providers
• Ensure access to community-based services
• Monitor referrals to community organizations and other services related to the member's care plan
• Actively participate in integrated care management rounds
• Identify and report risk management and quality concerns
• Maintain accurate clinical information in medical management systems

Education/Experience: Bachelor’s degree in Social Work. At least 2 years of social work experience in acute care or community settings. Knowledge of government sponsored managed care programs is preferred.

Licenses/Certifications: Current LMSW or LCSW license in the state.

For Sunshine Health (FL): An RN, LCSW, LMSW, LMHC or other Mental Health Professional license is required. Employees supporting Florida's Children’s Medical Services (CMS) must have one of the above professional licenses and either: 1. A minimum of two years of pediatric experience for Florida licensed registered nurses, or 2. A Master’s degree in social work or related field along with one year of related professional pediatric care experience. Up to 80% local travel may be required.

Additional Details:

• Licensing requirement: Master's degree in Social Work and LCSW, LMSW, LMHC

• Experience: Minimum of 1 year of pediatric experience

• Location: Residency in Miami-Dade County is required

• Travel: Up to 80% local travel

Our Comprehensive Benefits Package includes: Flexible work options such as remote work and hybrid schedules, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement, Best-in-class training and development opportunities.

Centene is an equal opportunity employer. We value diversity and appreciate the unique qualities that individuals from all backgrounds bring. 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 any other characteristic protected by applicable law.