Care Manager (RN)

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

Benefits offered by this job

Competitive benefits

Job summary

Centene Management Company LLC is seeking a Registered Nurse to develop and oversee complex care management for New Hampshire Health Families Medicaid members. The role emphasizes both physical and behavioral health to address whole-member needs.

You will coordinate care plans, educate families, and ensure timely access to services, working closely with providers and care teams within a state-focused Medicaid program.

Qualifications

• Requires Nursing degree and 2–4 years of related experience.
• RN state licensure required.

Responsibilities

• Evaluate member needs and barriers to care to develop a person-centered plan.
• Develop ongoing care/service plans and coordinate with providers to identify resources.
• Identify problems/barriers to care and provide care management interventions.
• Coordinate between member, family, and care team for appropriate services.
• Provide follow-up and monitor progress toward goals of the care plan.
• Offer resources for local services (housing, employment, etc.).
• Facilitate timely access to care and services with appropriate providers.
• May perform telephonic, digital, home, or other outreach to assess needs.
• Collect, document, and maintain member information ensuring regulatory compliance.
• Educate members and families on disease processes, care options, and benefits.
• Provide feedback to leadership for quality improvements.
• Other duties as assigned; comply with policies.

Skills

Care coordination

Care management

Patient education

Telephonic outreach

Documentation

Regulatory compliance

Education

Nursing degree (RN)

Job description

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

This position supports New Hampshire Health Families Medicaid population. Candidates should have both strong physical AND behavioral health experience to treat the whole member.

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

RN - Registered Nurse - State Licensure and/or Compact State Licensure required.

Pay Range

$56,200.00 - $101,000.00 per year

About Centene

At Centene, we connect people to the care they need to live healthier lives - and the work you do here makes that impact real every day. You'll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It's work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

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 & 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.