Care Manager (RN)

Meridian of Illinois; Illinois; Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible work schedules (remote,hybrid

Job summary

Centene is seeking an RN Care Manager for the Illinois YouthCare plan, a remote role with ~10% travel to Burr Ridge for quarterly meetings. Requires IL RN licensure, an IL-residing nurse with a bachelor's degree and 2–4 years of related experience, and knowledge of care coordination for Medicaid members.

The position offers flexible work arrangements (remote or hybrid), a Monday–Friday schedule, and competitive benefits, with pay range $56,200.00–$101,000.00 per year.

Qualifications

• Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2-4 years of related experience.
• IL RN licensure is required for YouthCare Illinois plan and must reside in IL.

Responsibilities

• Evaluates the needs of the member, barriers to accessing appropriate care, and recommends and/or facilitates the plan for the best outcome.
• Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and resources.
• Identifies problems/barriers to care and provide appropriate care management interventions.
• Coordinates between the member/family and the care provider team to ensure person-centered care.
• Provides ongoing follow up and monitoring of member status and revises care plans as needed.
• Provides resource support to members and care managers for local resources based on assessment.
• Facilitate care management to ensure timely access to needed care.
• May perform telephonic, digital, home, or other outreach to assess needs.
• Collects, documents, and maintains member information to ensure compliance with regulations.
• Educates members and families on disease processes, care options, and benefits.
• Provides feedback to leadership on opportunities to improve care and quality delivery.

Education

Bachelor's degree in Nursing

Degree from an Accredited School of Nursing

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.

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.

Key Details:

Role will support IL Health Plan Medicaid YouthCare program members. Applicants must reside in the state of IL in one of the following counties: Cook, Will, DuPage, Kane, Lake, McHenry, Grundy, Kendall or Kankakee. Applicants must have an IL Bachelor's degreed RN licensure.

This position is remote/work from home with approximately 10% travel to the Burr Ridge office for quarterly team meetings and, at times, may travel for face-to-face waiver member meetings if they reside close enough.

The work schedule is Monday - Friday, 8am - 5pm, central time zone.

• Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome
• Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs
• Identifies problems/barriers to care and provide appropriate care management interventions
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services
• Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs
• Provides resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate
• Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services
• May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
• Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
• Other duties or responsibilities as assigned by people leader to meet business needs
• Performs other duties as assigned.
• Complies with all policies and standards.

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.

License/Certification

• For YouthCare Illinois plan only: Bachelor's Degree and IL RN licensure required. Must reside in IL

Pay Range: $56,200.00 - $101,000.00 per year

Centene 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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