Senior Care Manager (RN)

Centene; United States; Remote; USD 73,000 - 133,000; Full time

Job summary

Join a forward-thinking organization that is dedicated to transforming healthcare for millions. This remote role focuses on complex care management, where you will develop personalized care plans, educate members and their families, and collaborate with healthcare providers to ensure quality care. You will play a crucial role in addressing unmet needs and improving health outcomes through effective communication and coordination. If you are passionate about making a difference in people's lives and thrive in a flexible work environment, this opportunity is perfect for you.

Benefits

Health Insurance

401K

Stock Purchase Plans

Tuition Reimbursement

Paid Time Off

Flexible Work Schedules

Qualifications

• Requires a degree in nursing with 4-6 years of related experience.
• RN licensure required for this role.

Responsibilities

• Develops and assesses ongoing care plans for members.
• Coordinates care between members and healthcare providers.
• Monitors member progress and revises care plans as needed.

Skills

Care Management

Patient Education

Collaboration with Healthcare Providers

Data Analysis

Spanish Speaking

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 position open to candidates in South FL Miami to Ft. Lauderdale.

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.

• Develops and continuously assesses ongoing care plans/service plans and collaborates with providers to identify providers, specialists, 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; 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.
• 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 regulations.
• 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 the gap between classroom training and field practice.
• Engages and assists New Hire/Preceptee during onboarding journey including responsibility for completing competency checkpoints 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.
• Spanish speaking a plus.

Education/Experience:

Requires a Degree from an Accredited School of 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: $73,800.00 - $132,700.00 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 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.