Senior Care Manager (RN)

Oklahoma Complete Health; New York (NY); On-site; USD 73,000 - 133,000; Full time

Job summary

A leading healthcare organization seeks a Registered Nurse to manage and implement care plans for members, ensuring quality healthcare outcomes. The role involves collaboration with providers, education for members, and continuous assessment of care plans. Competitive benefits and a diverse workplace are offered.

Benefits

Health Insurance

401K

Stock Purchase Plans

Tuition Reimbursement

Paid Time Off

Holidays

Flexible Work Arrangements

Qualifications

• 4–6 years of related experience required.
• NYS RN license required.

Responsibilities

• Develops and assesses ongoing care plans/service plans.
• Coordinates care between members and providers.
• Monitors member status and revises care plans as necessary.

Skills

Care Management

Patient Education

Collaboration

Education

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.

Position Purpose:

Assesses, plans, and implements complex care management activities based on member activities to enable quality, cost-effective healthcare outcomes. Develops a personalized care plan/service plan for care members, addresses issues, and educates members and their families/caregivers on services and benefit options available to receive appropriate high-quality care.

1. Develops and continuously assesses ongoing care plans/service plans and collaborates with providers to identify providers, specialists, and/or community resources needed to address the member's unmet needs.
2. Coordinates and manages 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.
3. Monitors care plans/service plans and/or member status, change in condition, and progress towards care plan/service plan goals; collaborates with the member, caregivers, and appropriate providers to revise or update care plans as necessary.
4. Identifies problems/barriers for care management and implements appropriate interventions for escalated cases.
5. Reviews member data to identify trends and improve operating performance and quality care in accordance with regulations.
6. Reviews referrals and assessments to develop appropriate care plans.
7. Performs outreach via telephonic, digital, home, or other site visits to assess needs and collaborate with resources.
8. Collaborates with healthcare providers to facilitate services and determine revised care plans if needed.
9. Maintains all member information and activities to ensure compliance with regulations.
10. Provides education to members and families on disease processes, care gaps, provider instructions, and healthcare benefits.
11. Partners with leadership to improve care delivery cost-effectively.
12. May precept new hires, coaching and facilitating their growth.
13. Supports onboarding and readiness of new clinical team members.
14. Collaborates with teams to monitor and measure readiness.
15. Performs other duties as assigned and complies with policies.

Education/Experience:

Requires a Degree from an accredited Nursing school or a Bachelor's degree in Nursing with 4–6 years of related experience. NYS RN license required. Pediatric experience preferred.

License/Certification:

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

Pay Range: $73,800.00 - $132,700.00 per year.

Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off, holidays, and flexible work arrangements.

Centene is an equal opportunity employer committed to diversity. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics.

Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws.