Maternal Child Health - RN Care Manager

Centene Management Company LLC; Iowa; Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K / stock plans

Tuition reimbursement

Paid time off

Flexible work arrangements

Job summary

Centene Management Company LLC is seeking a fully remote Case Manager RN to support the Start Smart for Your Baby program for pregnant members in Iowa. Preference for Iowa residents with an active Iowa RN license and prenatal care experience.

The role involves evaluating needs, developing care plans, coordinating with providers, and ensuring member-centered care with ongoing follow-up and education. Monday–Friday, CT business hours.

Qualifications

• Requires Iowa RN licensure and 2–4 years of related experience.
• Experience with prenatal/postpartum maternal health is preferred.
• OB/NICU exposure is a plus.

Responsibilities

• Evaluates member needs and barriers to determine priority actions.
• Develops care/service plans and coordinates with providers and resources.
• Identifies problems and applies appropriate care management interventions.
• Coordinates between member, family, and care providers for person-centered care.
• Provides follow-up and monitors progress toward care plan goals.
• Offers education to members and families on disease processes and benefits.

Skills

RN licensure

Case management

Prenatal care

Maternal health

Education

RN degree or BSN

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

This fully remote role involves completing case management related tasks for pregnant members in the state of Iowa for their "Start Smart for Your Baby" case management program. Preference will be given to applicants who (1) reside in Iowa, (2) have an Active Iowa RN license as well as (3) experience with case management and prenatal / post-partem maternal health. Experience with OB or NICU is a bonus. The schedule is Monday through Friday, 8-5 PM CT.

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 provides 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.
• Collaborates with member, caregivers, and appropriate providers to revise or update 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.
• Facilitates care management and collaborates 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.
• 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

Pay Range: $56,200.00 - $101,000.00 per year.

About the Company

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.

Equality & Diversity

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.

Further Information

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.