Senior Care Manager (RN)

Centene Management Company LLC; North Carolina; Hybrid; USD 75,000 - 135,000; Full time

Benefits offered by this job

Comprehensive benefits package

Job summary

Centene Management Company LLC is seeking a remote Care Manager RN in North Carolina. The ideal candidate will hold an active North Carolina RN license and bring pediatric CMARC experience, superb assessment skills, and strong communication with families and care teams.

The role focuses on developing individualized care plans, coordinating with providers, and monitoring progress to ensure high-quality, cost-effective care.

Qualifications

• Active RN license in North Carolina
• Experience with pediatric population (CMARC) preferred
• Strong assessment skills and problem-solving abilities
• Proficient with Microsoft applications and data entry
• Excellent communication and patient/customer service skills
• Detail-oriented with strong time-management and organizational abilities

Responsibilities

• Develops and continuously assesses care plans/service plans with providers to address unmet needs.
• Coordinates between members, families/caregivers, and care teams to ensure person-centered care.
• Monitors and revises care plans to meet member goals and changing needs.
• Identify barriers to care and escalate appropriately.
• Review member data to identify trends and improve quality and regulatory compliance.
• Communicate with providers to align on treatments and revised plans.

Skills

Assessment skills

Communication

Customer service

Time management

Organizational skills

Computer proficiency

Education

Bachelor's degree in Nursing

Accredited School of Nursing degree

Tools

Microsoft Office

Job description

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/care givers on services and benefit options available to receive appropriate high-quality care.

Key Details

This is a remote position, and applicants must reside in North Carolina and hold an active RN license. The ideal candidate will have experience working with the pediatric population, specifically in CMARC (Care Management for At-Risk Children), as well as experience in care management. Candidates should possess strong assessment skills and computer proficiency, including experience with Microsoft applications. They should also demonstrate excellent communication and customer service skills, attention to detail, strong organizational and management abilities, and effective time management skills. The work schedule is Monday through Friday, from 8:00 AM to 5:00 PM.

Job Responsibilities

• Develops and continuously assesses ongoing care plans / service plans and collaborates with providers to identify providers, specialist, and/or community resources needed to address member's unmet needs
• Coordinates and manages 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
• Monitors care plans / service plans and/or member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs
• May identify problems/barriers for care management and appropriate care management interventions for escalated cases
• Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations
• Reviews referrals information and intake assessments to develop appropriate care plans/service plans
• May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
• Collaborates with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed
• 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
• Partners with leadership team to improve and enhance care and quality delivery for members in a cost-effective manner
• May precept clinical new hires by fostering and building core skills, coaching and facilitating their growth, and guiding through the onboarding process to upskill readiness
• Provides guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities to bridge gap between classroom training and field practice
• Engages and assists New Hire/Preceptee during onboarding journey including responsibility for completing competency check points ensuring readiness for Service Coordination success
• Engages in a collaborative and ongoing process with People Leaders and cross functional teams to measure and monitor readiness
• Other duties or responsibilities as assigned by people leader to meet business needs
• Performs other duties as assigned.
• Complies with all policies and standards.

Education / Experience

Requires a Degree from an Accredited School or Nursing or a Bachelor's degree in Nursing and 4 – 6 years of related experience.

License / Certification

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

Pay Range

$75,300.00 - $135,400.00 per year.

Employer Overview

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

• 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, including full-time or part-time status.
• Total compensation may also include additional forms of incentives.
• Benefits may be subject to program eligibility.

Equal Opportunity and Diversity Statement

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.

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.