Remote RN Care Management Lead - CA

Centene Management Company LLC; California (MO); Hybrid; USD 103,000 - 191,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

tuition reimbursement

paid time off plus holidays

remote, hybrid, field or office work

Job summary

Centene is seeking an experienced registered nurse to lead its care management team and oversee the care of members to ensure high-quality, cost-effective outcomes. The role requires active California licensure and a strong grasp of regulatory and NCQA standards.

This remote position offers PST hours, a pay range of $102,900 to $190,500 per year, and benefits including health insurance, 401K and tuition reimbursement.

Qualifications

• RN California license required.
• Graduate from an Accredited School of Nursing or Bachelor's degree with 5+ years of related experience.
• UM and CM experience preferred.

Responsibilities

• Manages the care management team and care management of members to develop high-quality, cost-effective outcomes.
• Oversees escalations and care management issues related to members or providers.
• Reviews documentation to maintain compliance with federal/state regulations and NCQA standards.
• Directs daily activities of care management staff and approves caseloads based on state requirements.
• Manages processes for escalation and complex cases and guides team members.
• Coordinates resolutions of member escalations/complaints and supports audits/evaluations.

Skills

Team management

Regulatory compliance

Policy development

Education

Graduate from an Accredited School of Nursing

Bachelor's degree

Job description

Centene is seeking an experienced registered nurse to lead its care management team and oversee the care of members to ensure high-quality, cost-effective outcomes. The role requires active California licensure and a strong grasp of regulatory and NCQA standards.

This remote position offers PST hours, a pay range of $102,900 to $190,500 per year, and benefits including health insurance, 401K and tuition reimbursement.