New

Care Manager

Spectraforce Technologies

United States, Florida, Miami

Apr 12, 2025

Title: Care Manager (RN)

Duration: 03 Months - Contract to Hire

Location: Remote FL (Member Facing) - Candidate must reside within region 11 - Miami Dade; Monroe

Face to face visits, Caseload based travel (80%/30%), Max 50 mile radius

Leadership works to have the new hire work within a 50-mile radius - may vary based on caseload

Monday - Friday 8-5 EST

Position Purpose:

Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families.

Responsibilities:

Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
Coordinate care (finding providers)
Assisting in authorization
Creating assessments and care plans
Required to complete daily outreach calls based on member specific tiers
Based on members needs the call volume will vary 5-20 calls per day
Contractual obligation is a weighted 200 caseload
Tier 3 - 2.2
Tier 4 - 1
Outreach calls are to check in on the members, follow up on their needs, remove any barriers to care for the members.
Ensuring that the children's needs are met (having issues at school, having a home health aide to assist)
Leadership will complete chart and call audits on a monthly basis or as needed.
Documentation is key

Education/Experience:

Requires a Degree from an Accredited School of Nursing or a bachelor's degree in nursing and 2 - 4 years of related experience.

Candidate Requirements
Education/Certification	Required: Requires a Degree from an Accredited School of Nursing or a bachelor's degree in nursing and 2 - 4 years of related experience.	Preferred: n/a
Licensure	Required: RN - Registered Nurse - State Licensure and/or Compact State Licensure required"	Preferred: n/a
Years of experience required Disqualifiers Best vs. average Performance indicators	Must haves: 2+ years of social work experience or licensed mental health counselor in an acute care or community setting. Experience connecting families/children to local resources for various services including employment, housing, independent living, justice, foster care, etc. Behavioral Health Experience Strong communication Time management Critical thinking Computer literacy and Microsoft office (excel) filtering, - moderate level Nice to haves: Health plan experience Foster care and/or adoption experience Bi-Lingual Knowledge of government sponsored managed care programs preferred. Psych background as long as the license is there with it BA Case Management as a RN Performance indicators: Individuals will be audited monthly to ensure charts are in compliance. KPI metrics (are they meeting their monthly/quarterly outreach/ completing care plans, completion of annual assessments)
Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection	1	Pediatric experience (2 years) - would love case management but not required precisely
2	Bi-Lingual
3	Behavioral Health Experience (training, certification, etc.)

Position is offered by a no fee agency.