Care Manager Transition of Care

Centene; United States; Remote; USD 55,000 - 99,000; Full time

Job summary

An established industry player is seeking a dedicated care management professional to enhance the health of its members. In this impactful role, you will assess and coordinate medical services for post-discharge members, ensuring a seamless transition and promoting quality care. You'll collaborate with a variety of healthcare professionals to develop personalized care plans, while also providing essential education and resources to members. This position offers a flexible work environment and a comprehensive benefits package, making it an exciting opportunity for those passionate about improving community health and member well-being.

Benefits

Health insurance

401K

Stock purchase plans

Tuition reimbursement

Paid time off

Flexible work schedules

Qualifications

• Requires a nursing degree and 2-4 years of related experience.
• Bilingual preferred for effective communication with diverse members.

Responsibilities

• Perform care management duties for post-discharge members.
• Develop care/service plans and collaborate with healthcare teams.
• Assess member needs and facilitate transitions into active care.

Skills

Care management

Medication reconciliation

Assessment skills

Collaboration with interdisciplinary teams

Education and resource facilitation

Telephonic outreach

Education

Degree from an Accredited School of Nursing

Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Performs care management duties to assess, plan and coordinate aspects of medical and supporting services across the continuum of care for post-discharge members, promoting quality and cost effective care. Completes medication review for pre-admission and post-discharge reconciliation. Works with the care management and coordination teams to identify transition support services.

• Must reside in WA
• Bilingual preferred
• Evaluates the needs of the member by completing post discharge assessments for members transitioning from healthcare facilities
• Evaluates medication and performs reconciliation between pre-admit and post-discharge medications
• Develops a care/service plan and collaborates with discharge planners, providers, specialists, and interdisciplinary teams to support member transition and discharge needs
• Assesses member current health status, resource needs, services, and treatment plans and provides appropriate interventions
• Facilitates the transition into active care management based on member needs
• Provides or facilitates education and resource materials to members, authorized caregivers, and providers to promote wellness activities to improve member overall quality of care
• Facilitates services between Primary Care Physician (PCP), specialists, medical providers, and non-medical resources as necessary to meet the medical and socio economic needs of members
• 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 regulations
• 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
• Complies with all policies and standards

Education/Experience: Requires a Degree from an Accredited School of Nursing and 2 – 4 years of related experience.

License/Certification:

• RN required

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

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. Total compensation may also include additional forms of incentives.

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.