Pediatric Care Manager, RN (ECC)

RemoteWorker CA; Miami (FL); Remote; USD 54,000 - 98,000; Full time

Job summary

An established industry player is seeking a dedicated RN to transform healthcare for its members. This remote role involves developing personalized care plans and facilitating complex care management activities. With a focus on pediatric care, you will evaluate member needs, coordinate with providers, and ensure quality healthcare outcomes. Enjoy a flexible work environment and a comprehensive benefits package, including health insurance, 401K plans, and tuition reimbursement. If you are passionate about making a difference in the lives of children and their families, this opportunity is perfect for you.

Benefits

Health Insurance

401K

Tuition Reimbursement

Paid Time Off

Flexible Work Schedules

Qualifications

• Requires RN licensure and 2-4 years of related pediatric experience.
• Strong focus on developing and implementing care plans.

Responsibilities

• Evaluate member needs and barriers to care, developing personalized care plans.
• Coordinate with providers to ensure timely access to services.

Skills

Pediatric Care Management

Care Plan Development

Patient Education

Problem Solving

Communication Skills

Education

Degree from an Accredited School of Nursing

Bachelor's degree in 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.

This is a remote/work-from-home opportunity with local travel required for member visits. Candidates should reside in one of the following counties in Florida to be considered for this role: Nassau or Duval, with preference given to those in the northeastern part of Duval County. Two years of pediatric experience is required.

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.

• 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 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.
• 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.
• 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 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.
• For Sunshine Health (FL) Only: Employees supporting Florida's Children’s Medical Services (CMS) must have a minimum of two years of pediatric experience.

Pay Range: $54,000.00 - $97,100.00 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