New

Care Manager

Spectraforce Technologies

United States, Florida, Fort Lauderdale

Apr 28, 2025

Title: Care Manager

Location: Member Facing - Broward County (20% - 30% Travel required)

Duration: 03 Months (Contract to Hire)

Shift: 8 AM to 5 PM EST

Responsibilities:

May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources
Managing Tier 4 (only face to face on enrollment) and Tier 3 (quarterly visits) won't have more than 12. 4 visits every month on average
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
COORDINATING CARE FOR SPECIAL NEEDS FAMILY ON THE CMS PLAN; Needs based assessments ONLY not diagnostic; Acute Members with Medications
CASELOAD COMPLIANCE PER CMS CONTRACT. FIELD VISITS, ASSESSMENTS, CARE PLANS
Current caseload weighted average of 200 Members per CM
Mostly Tier 4 (quarterly calls & face-to-face visits on enrollment); Tier 3 has quarterly visits (4 visits/monthly, but not a guarantee)
Averaging between 200-225, but future goal to drop to 150, but depends on case load
Pediatric Case Management: Calls to and from members to coordinate services; home visits; completion of assessment packets; meetings and trainings at times.
Autonomous and able to set own schedules for member calls/assessments

Works closely together and willing to assist each other when needed

Qualifications:

Candidate Requirements
Education/Certification	Required: Education/Experience: Requires a Master's degree in Behavioral Health or Social Work and 2 - 4 years of related experience.	Preferred:
Licensure	Required: LCSW/LMHC license active in Florida	Preferred:

Must-Haves:

1	Pediatrics - Minimum of 2 years
2	Knowledge of Electronic Health Record (EHR), keyboarding, 2+years of Pediatric Nursing Experience; Soft skills in communicating with members by phone and in person, as well as via email. Microsoft Office (PowerPoint, Word, Excel); Bilingual skills an asset (Spanish, Creole, Portuguese)

Position is offered by a no fee agency.