Pediatric Care Manager, RN (ECC)

RemoteWorker CA; Royal Palm Beach (FL); Remote; USD 55,000 - 99,000; Full time

Job summary

An established industry player in healthcare is seeking a dedicated Registered Nurse to join their team. This remote position offers the opportunity to make a significant impact on the lives of members by developing personalized care plans and addressing the unique needs of pediatric patients. With a focus on collaboration and member engagement, you will work closely with families and healthcare providers to ensure high-quality care delivery. Enjoy a flexible work environment with competitive benefits, including health insurance and tuition reimbursement. If you are passionate about improving healthcare outcomes for children, this role is perfect for you.

Benefits

Health Insurance

401K Plan

Tuition Reimbursement

Paid Time Off

Flexible Work Schedules

Qualifications

• Minimum 2 years of pediatric experience required.
• Degree in Nursing or equivalent required.

Responsibilities

• Develop and facilitate complex care management activities.
• Evaluate member needs and coordinate care plans with providers.
• Provide education to members and families on healthcare options.

Skills

Pediatric Care

Care Management

Patient Education

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 position is remote, with some local travel required for member visits up to 25% of the time. Candidates must reside in the Tampa, Florida area to be considered for the role. A minimum of 2 years of pediatric experience is required, and preference will be given to those with experience working with medically complex children.

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.

1. 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.
2. Develops ongoing care plans/service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs.
3. Identifies problems/barriers to care and provides appropriate care management interventions.
4. 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.
5. 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.
6. 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.
7. Facilitates care management and collaborates with appropriate providers or specialists to ensure member has timely access to needed care or services.
8. May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources.
9. Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulations.
10. 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.
11. Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner.
12. Other duties or responsibilities as assigned by people leader to meet business needs.
13. Performs other duties as assigned.
14. 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.
• 2 years (minimum) of pediatric experience is 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