Care Manager (RN)

Centene Management Company LLC; South Carolina; 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 and holidays

Flexible remote/hybrid/work schedule

Job summary

Centene Management Company LLC in South Carolina is seeking a registered nurse to develop and facilitate complex care management for members with physical health needs. The role emphasizes personalized care plans, education for members and families, and high-quality, cost-effective outcomes.

The position is remote, requires SC residency, and an active RN license. Expect a Monday–Friday schedule from 8:00 AM to 5:00 PM with strong communication, computer skills, and attention to detail guiding

Qualifications

• Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2–4 years of related experience.
• Active RN license in South Carolina or Compact State licensure.
• Remote position with SC residency and strong communication skills.

Responsibilities

• Evaluates member needs, barriers to care, and social determinants to plan outcomes.
• Develops care plans and collaborates with providers to address unmet needs.
• Identifies problems and provides care management interventions.
• Coordinates between members, families, and providers for person-centered care.
• Monitors status and updates care plans to meet goals.
• Provides resource support for local services based on assessments.
• Facilitates care management with appropriate providers for timely access.
• May conduct telephonic, digital, or home outreach to assess needs.
• Documents and maintains member information to ensure regulatory compliance.
• Delivers education to members and families on disease processes and benefits.
• Provides leadership feedback for quality improvements.

Skills

Communication

Customer service

Assessment

Critical thinking

Care management

Time management

Attention to detail

Education

Bachelor's degree in Nursing

Accredited Nursing School degree

Tools

Computer skills

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 is a remote position; however, applicants must reside in South Carolina. Candidates must have an active RN license. The ideal candidate is computer savvy and has excellent communication and customer service skills, strong assessment and critical-thinking skills, care management experience, effective time-management skills, and a strong attention to detail. The work schedule is Monday through Friday, 8:00 AM to 5:00 PM.

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

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

Benefits

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• 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.

Company Culture

At Centene, we connect people to the care they need to meet their goals and the work you do helps bring out the best in people – 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.

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.

Mission Statement

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.