LPN
Company: Sunshine State Health Plan
Location: Hialeah
Posted on: October 25, 2024
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 remote/work-from-home with local travel required
for member visits. Candidates must reside in Orange, Osceola, or
Seminole Counties in Florida to be considered for this role. 2
years of pediatric experience required. Bilingual
preferred.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.
- 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 standardsEducation/Experience:
Requires a Master's degree in Behavioral Health or Social Work and
2 - 4 years of related experience.
License/Certification:
- Licensed Behavioral Health Professional based on state contract
requirements e.g., LCSW, LMSW, LMFT, LMHC, LPC with BH experience
required
- For Sunshine Health (FL) Only: Employees supporting Florida's
Children's Medical Services (CMS) must have a minimum of two years
of pediatric experiencePay Range: $54,000.00 - $97,100.00 per
yearCentene 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
Keywords: Sunshine State Health Plan, Deerfield Beach , LPN, Healthcare , Hialeah, Florida
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