Case Manager Job at Sunshine State Health Plan, Hialeah, FL

WHFpUm4wam56dkgzYVhXVEF0TzN1WkhxTUE9PQ==
  • Sunshine State Health Plan
  • Hialeah, FL

Job Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

*** This position is field based with in-person visits to member homes or facilities required up to 75% of the time. 25% of the role is remote/home based. Candidates should reside in the city of Sarasota or Venice, FL to be considered for the role. ***

Position Purpose: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

  • Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
  • Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
  • Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
  • Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
  • Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
  • Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
  • Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
  • May perform home and/or other site visits to assess member’s needs and collaborate with healthcare providers and partners
  • Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
  • Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience: Requires a Bachelor's degree and 2 – 4 years of related experience.

Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Additional Information:

  • Candidates should reside in the cities of Venice or Sarasota, FL to be considered for the role

Pay Range: $26.50 - $47.59 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

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.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Job Tags

Hourly pay, Holiday work, Remote job, Flexible hours,

Similar Jobs

The Cigna Group

Medical Managing Director, Client Growth, Management and Innovation- Cigna Healthcare Job at The Cigna Group

 ...difference in our success.* Flexible Onsite Location: Willing to consider other onsite locations.OVERVIEW/DESCRIPTION:As a member of the Cigna Healthcare (CHC) Clinical Leadership team, this role will report directly to the Chief Medical Officer (CMO) for Cigna Healthcare... 

UnityPoint Health

Paramedic Job at UnityPoint Health

Overview: Paramedic Full-Time; 24hr Shifts Eligible for a $5,000 Sign-on Bonus! As a member of our interdisciplinary team, contributes professional prehospital EMS knowledge and skills to patients and their families. Maintains excellent patient service skills... 

Mission Essential

Intelligence Analyst Job at Mission Essential

 ...Position: Imagery Analyst (FMV) Location: Suitland, MD Clearance: TS/SCI Salary Range: 80-90K Job Description: Mission...  ...years of practical work experience exploiting NTM and/or airborne intelligence, surveillance and reconnaissance imagery Full Motion Video (... 

Elite Retreat Massage and Health Spa

Massage Therapist Job at Elite Retreat Massage and Health Spa

 ...flexible hours, and love working in an environment that feels like family? Let's talk. Our wellness facility is looking for a seasoned massage therapist to join our growing team. Our ideal candidate is personable, committed to cultivating an excellent rapport with every... 

The Castle Fun center

$50/H Data Analyst (Entry-Level) Remote Job at The Castle Fun center

Job Title: Entry-Level Data Analyst (Remote) Hourly Rate: $50/hour Job Summary: We are seeking an enthusiastic and detail-oriented Entry-Level Data Analyst to join our remote team. In this role, you will assist in collecting, analyzing, and interpreting data to...