Remote Pediatric Case Manager

Remote Pediatric Case Manager Role

Job Description

The Pediatric Case Manager plays a crucial role in managing complex and chronic conditions within a pediatric population in a managed care environment. This position collaborates with providers, hospitals, and multidisciplinary teams to coordinate care, close gaps, and enhance health outcomes while minimizing avoidable utilization. This role is local for South Florida applicants; remote for North Florida applicants.

• Conduct comprehensive needs assessments and stratify risk.
• Develop individualized care plans aligned with evidence‑based guidelines.
• Review inpatient census activity and coordinate discharges.
• Conduct outreach to high‑risk members and provide disease‑specific education.
• Empower patients and families in self‑management.
• Operate in compliance with Medicaid requirements and PCMH standards.
• Support cost‑effective care delivery and improve members' quality of life.

• Active Florida RN license.
• Bachelor’s Degree in Nursing (BSN required; MSN preferred).
• 3–5 years of clinical nursing experience.
• Hands‑on case management experience, preferably within managed care or population health.
• Pediatric (PED) or PICU clinical experience supporting medically complex populations.

Job Type &

Location:

This is a Contract position based out of Miami, FL. This is a hybrid position in Miami, FL.

Pay Range: $40.00 - $44.00/hr.

Benefits:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre‑tax and Roth post‑tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long‑term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Final date to receive applications:
This position is anticipated to close on Jun 26, 2026.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccom for other accommodation options.