Care Manager (RN)

Centene Corporation

Topeka (KS)

Hybrid

USD 56,000 - 101,000

Full time

3 days ago
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Benefits offered by this job

Health insurance
401K stock purchase plan
Tuition reimbursement
Paid time off
Flexible work schedules

Job summary

Centene Corporation is seeking a Nurse Care Manager to develop and facilitate complex care management for members with physical health needs. You will evaluate barriers to care, coordinate with providers and caregivers, and maintain detailed care plans to achieve optimal outcomes.

The role emphasizes ongoing follow-up, resource coordination, and timely access to services, with a flexible schedule including remote, hybrid, field, or office work options.

Qualifications

  • Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2–4 years of related experience.
  • RN - Registered Nurse licensure required or Compact State Licensure.
  • YouthCare Illinois / Sunshine Health / Trillium plan-specific licensure requirements may apply.

Responsibilities

  • Develops and facilitates complex care management for members with primarily physical needs.
  • Evaluates member needs and barriers to accessing care, focusing on priority goals.
  • Collaborates with providers to identify resources and create individualized care plans.
  • Coordinates between members, families and care teams to ensure appropriate, person-centered services.
  • Monitors member status, revising care plans as needed to meet goals and changes in condition.

Skills

Care coordination
Patient education
Nursing knowledge

Education

Bachelor's degree in Nursing
Degree from an Accredited School of Nursing

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.

  • 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
  • For YouthCare Illinois plan only: Bachelor’s Degree and IL RN licensure required. Must reside in IL
  • For Sunshine Health (FL) Only: Employees supporting Florida's Children’s Medical Services (CMS) must have a minimum of two years of pediatric experience. May require up to 80% local travel required
  • For Trillium Community Health Plan Only: RN (Registered Nurse) licensure in Oregon required

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

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.

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.

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

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