Care Manager

Spectraforce Technologies

United States, Florida, Green Cove Springs

Apr 15, 2025

Title: Care Manager

Duration: 3 Months (Potential to extend/convert FTE)

Location: Remote - Face-to-face visits at members' homes/other agreed-upon public locale. Highest need Clay, Duval, Volusia

Mon-Fri 8A-5P

Job Description:

COORDINATING CARE FOR SPECIAL NEEDS FAMILY ON THE CMS PLAN
Set tasking of assigned caseload Max 200 members
Virtual with a couple of in person meetings per year
Remote/Autonomous high tech work environment with field visits and telephone contact of members
Combination of Tier 3&4 (A good mix of both, but majority of Tier 4)
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

Candidate Requirements
Education/Certification	Required: Master's Degree	Preferred: none
Licensure	Required: LCSW/LMHC license active in Florida	Preferred: None
Years of experience required Disqualifiers Best vs. average Performance indicators	Must haves: Pediatrics - Minimum of 2 years Nice to haves: Bilingual Spanish/English preferred, Experience with electronic medical records, Basic Excel skills; medical background (hospital setting) Disqualifiers: Non licensure Performance indicators: Caseload compliance Best vs. average:
Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection	1	Technology including Microsoft and EMR
2	Problem solving
3	Resource providing

Position is offered by a no fee agency.