Care Manager (RN)

Centene Management Company LLC; Wisconsin; 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 plus holidays

Flexible remote/hybrid schedule

Job summary

Centene Management Company LLC in Wisconsin seeks an experienced RN for a remote Care Management role to support the Start Smart for Baby program. The ideal candidate resides in Wisconsin and holds an active RN license with OB/NICU/postpartum experience.

You will assess member needs, develop and coordinate personalized care plans, and collaborate with providers to ensure timely access to services. Education to members and families is required, with ongoing follow-up and care plan revisions as

Qualifications

• Requires an RN license and nursing degree.
• 2–4 years of related experience.
• Wisconsin residency and active WI RN licensure preferred.

Responsibilities

• Evaluates member needs and barriers to care and recommends or facilitates a personalized care plan.
• Develops and updates care/service plans with providers and resources to address unmet needs.
• Identifies problems/barriers to care and initiates appropriate interventions.
• Coordinates between member/family and care team to ensure person-centered care.
• Provides ongoing follow up and monitors progress toward goals and revises plans as needed.
• Provides education to members and families on disease processes, care options, and benefits.

Skills

RN license

Care coordination

Communication

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.

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.

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 and 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 and Certification

RN - Registered Nurse - State Licensure and/or Compact State Licensure required

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
• flexible approach to work with remote, hybrid, field or office work schedules

About Centene

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.

Equal Opportunity Employer

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