Care Manager (RN)

Sunshine Health; Orlando (FL); Remote; USD 55,000 - 99,000; Full time

Job summary

An established industry player is seeking a dedicated Care Manager (RN) to transform healthcare for its members. This fully remote position emphasizes personalized care plans and collaboration with healthcare providers to ensure optimal outcomes. The role requires a strong background in nursing and care management, with a focus on evaluating member needs and facilitating access to necessary services. Join a team committed to improving community health and enjoy a comprehensive benefits package that includes competitive pay, flexible work options, and opportunities for professional growth. If you're passionate about making a difference in healthcare, this role is for you.

Benefits

Health Insurance

401K

Tuition Reimbursement

Paid Time Off

Flexible Work Schedules

Qualifications

• Degree from an accredited nursing school or Bachelor's in Nursing required.
• 2 - 4 years of related experience in care management.

Responsibilities

• Develops and facilitates complex care management activities for members.
• Coordinates between members and care providers to ensure adequate services.
• Provides education on disease processes and healthcare options.

Skills

Care Management

Patient Assessment

Healthcare Education

Communication

Education

Bachelor's degree in Nursing

Job description

Join to apply for the Care Manager (RN) role at Sunshine Health

Join to apply for the Care Manager (RN) role at Sunshine Health

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 position is fully remote. Candidates are required to live in Florida to be considered for the role. FL RN licensure 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 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
  
  

Additional Information

• Location Fully remote position within the state of Florida - FL residency required
• Hours Monday - Friday, 8AM - 5PM EST
• Short-term case management 90 days
• Caseload 73 active plus additional, new referrals as assigned
  
  

Pay Range $55,100.00 - $99,000.00 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. Total compensation may also include additional forms of incentives.

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

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care and Insurance

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