Care Manager (RN)

Centene Management Company LLC; Illinois; Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible remote/hybrid schedule

Job summary

Centene is seeking an RN for the IL YouthCare program, working remotely with about 10% travel to Burr Ridge for quarterly meetings. The role serves Medicaid YouthCare members in Illinois, with a Monday–Friday 8am–5pm Central schedule.

The ideal candidate has an IL nursing license, a degree from an accredited nursing program, and 2–4 years of related experience.

Qualifications

• Requires a degree from an Accredited School of Nursing or a Bachelor's degree in Nursing with 2-4 years of related experience.
• License/Certification: IL RN licensure required (YouthCare Illinois plan).

Responsibilities

• Evaluates the needs of the member, barriers to accessing care, and social determinants of health to plan outcomes.
• Develops ongoing care plans and collaborates with providers to address unmet needs.
• Identifies problems/barriers to care and provides care management interventions.
• Coordinates between member/family and care provider team to ensure person-centered care.
• Provides follow up and monitors status to update care plans as needed.
• Provides resource support to members for local services based on assessments.
• Facilitates care management to ensure timely access to needed care or services.
• May perform telephonic, digital, home, or other site outreach to assess member needs.

Education

Degree from Accredited School of Nursing

IL RN licensure

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.

Responsibilities:

• 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.

Pay Range:

• $56,200.00 - $101,000.00 per year

Benefits:

• 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.

Equal Opportunity and Diversity:

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.

About Centene:

Centene is committed to helping people live healthier lives. We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.