Care Manager (RN)

Centene Corporation; Town of King (WI); A distancia; USD 56.000 - 101.000; Jornada completa

Descripción de la vacante

Centene Corporation seeks a remote Care Management RN to support the MHS Wisconsin plan, focusing on Start Smart for Baby and maternal health needs. The ideal candidate holds an active RN license and has OB, NICU, and postpartum care experience, with residency in Wisconsin.

Responsibilities include assessing needs, developing care plans, coordinating with providers, and ensuring timely access to services. This role emphasizes person-centered care, ongoing follow-up, and collaboration with family

Formación

• 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 - State Licensure and/or Compact State Licensure required

Responsabilidades

• Evaluates member needs and barriers to care, prioritizes, and facilitates the care plan.
• Develops care/service plans and coordinates with providers to address unmet needs.
• Identifies barriers to care and provides appropriate interventions.
• Coordinates between member/family and care team to ensure person-centered care.
• Provides follow up, monitors status, and revises plans as needed.
• Provides resource support for local services and supports access to care.
• Facilitates care management and timely access to needed care or services.
• May conduct telephonic, digital, home, or other outreach to assess needs.
• Documents all information to ensure regulatory compliance.
• Educates members and families on disease processes and care options.

Conocimientos

OB care

NICU

Postpartum care

Care management

Educación

Bachelor's degree in Nursing

Degree from Accredited School of Nursing

Descripción del empleo

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:

Join Centene as a remote Care Management (RN), supporting our MHS Wisconsin plan. In this role, you will support our Start Smart for Baby program. The ideal candidate will reside in Wisconsin, hold an active RN license, and has experience in OB, NICU, and postpartum care.

• 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

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