Care Manager (RN) - Child Welfare

Centene; Myrtle Point (OR); Remote; USD 55,000 - 99,000; Full time

Job summary

A healthcare management company is seeking a care manager to support children with complex healthcare needs. Applicants should hold an RN license and possess at least 2 years of pediatrics experience. The role involves developing care plans, collaborating with providers, and offering resources to members. This position offers a flexible work schedule and a comprehensive benefits package including health insurance, 401k, and tuition reimbursement.

Benefits

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Qualifications

• Requires at least 2 years of experience in pediatrics.
• RN - Registered Nurse State Licensure required.
• Strong understanding of healthcare compliance and regulations.

Responsibilities

• Develop care management activities focusing on physical needs.
• Evaluate member needs and recommend care plans.
• Coordinate between members and care providers.

Skills

Care management

Pediatrics experience

Effective communication

Resource support

Education

Degree from an Accredited School of Nursing

Bachelor's degree in Nursing

Job description

Applicants for this role have the flexibility to work remote from their home anywhere within the state of Florida. This role supports children and requires a Florida RN license and at least 2 years of pediatrics experience. The work schedule is Monday - Friday, 8am - 5pm.

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.

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

Compensation

Pay Range: $55,100.00 - $99,000.00 per year

Benefits

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.

Equal Opportunity Employment

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