Complex Discharge Planner

Centene Management Company LLC; Arizona; Hybrid; USD 37,000 - 68,000; 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/field or office

Job summary

Centene Management Company LLC is seeking a Registered Nurse for a fully remote discharge planning role. You will develop complex discharge plans for high-risk members and coordinate seamless transitions from acute care to the next level of care in a telephonic environment.

Requires an active RN license (Compact State licensure preferred) and 2+ years of acute care experience. Knowledge of Medicare/Medicaid regulations and utilization management is a plus.

Qualifications

• Graduate from an accredited school of nursing or BSN required.
• 2–4 years of related experience required.
• Clinical knowledge of discharge planning competencies preferred.
• Knowledge of Medicare/Medicaid regulations preferred.
• Knowledge of utilization management processes preferred.

Responsibilities

• Develops discharge plans based on needs assessment to ensure appropriate level of care.
• Coordinates with providers and community agencies to ensure safe transitions.
• Assists with timely discharge between levels of care and facilities.
• Maintains discharge plans in health management systems according to policy.
• Educates members and families on discharge plan and utilization processes.
• Provides feedback to leadership to improve discharge planning.

Skills

Acute care experience

Discharge planning

Medicare/Medicaid knowledge

Utilization management

Education

Graduate from an Accredited School of Nursing

Bachelor's degree in Nursing

Job description

Position Purpose:

Develops, assesses, and coordinates complex discharge plans for high-risk members based upon needs assessment. Assists with the facilitation of a smooth transition from the acute care setting to the next level of care and educates members and their families/caregivers on discharge plan to ensure appropriate high-quality transitional care.

Key Details:

• This is a fully remote opportunity that requires an active Compact RN License.
• Prior Case Management and/or Discharge Planning experience working in a telephonic environment highly preferred.
• Develops complex discharge plans based on level of care of members needs determined by needs assessment to ensure appropriate level of care
• Interacts with providers, community agencies, and other utilization review staff to coordinate and ensure a safe, effective, and clinically appropriate transition plan for the member
• Assists with managing member’s discharge plans to ensure a timely and smooth discharge between levels of care and facilities
• Collects, documents, and maintains all discharge plans taken on member medical records in health management systems according to utilization management policies and guidelines
• Assists with providing education to members and their families on discharge plan and utilization processes to ensure high quality appropriate care to members, as applicable
• Provides feedback to leadership on opportunities to improve the discharge planning process for members to ensure high-quality transitional care
• Coordinates and assists with completion of prior authorizations as they related to discharge planning, as applicable
• Assists concurrent review team as needed
• Performs other duties as assigned
• Complies with all policies and standards

Education / Experience:

• Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 – 4 years of related experience.
• 2+ years of acute care experience required.
• Clinical knowledge of discharge planning competencies preferred.
• Knowledge of Medicare and Medicaid regulations preferred.
• Knowledge of utilization management processes preferred.

License / Certification:

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

Pay Range:

$27.02 - $48.55 per hour

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.

Benefits:

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• 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:

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.

Centene is committed to helping people live healthier lives. We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.