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Care Manager (RN)

Oklahoma Complete Health

Orlando (FL)

Remote

USD 60,000 - 90,000

Full time

Yesterday
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Job summary

An innovative organization is seeking a dedicated Registered Nurse to enhance the health of communities through effective care management. This remote role focuses on developing personalized care plans for members, addressing their physical needs, and ensuring they receive high-quality, cost-effective healthcare outcomes. The ideal candidate will have NICU experience and be passionate about supporting members and their families with educational resources and care coordination. Join a forward-thinking team that values flexibility and community health improvement, making a real difference in the lives of many.

Qualifications

  • 2–4 years of related experience in care management or nursing.
  • Strong assessment and communication skills required.

Responsibilities

  • Develop and facilitate personalized care plans for members.
  • Coordinate care between members, families, and providers.
  • Monitor member progress and update care plans as needed.

Skills

Care Management
Patient Education
Assessment Skills
Communication
Bilingual (Spanish)

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.

***This is a remote position, but candidates must reside and be licensed in the State of Florida to be considered for the role. NICU experience required.***

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.

  • 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 provides 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; collaborates 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.
  • Facilitates care management and collaborates 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
  • NICU experience required
  • Bilingual Spanish speakers strongly preferred
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