Senior Care Manager RN - STAR/CHIP

Centene Corporation; Austin (TX); Vor Ort; USD 75.000 - 135.000; Vollzeit

Benefits dieser Stelle

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements (remote/hyb

Zusammenfassung

Centene in Austin, TX is seeking a Senior Care Manager RN to assess, plan, and implement complex care management activities. You will develop personalized care/service plans, coordinate with providers, and educate members and families on benefits to achieve high-quality, cost-effective outcomes.

The role focuses on chronic disease management and collaboration with state programs (Medicaid/STAR CHIP). Typical hours are 8–5 CST, with options for remote/hybrid schedules and leadership in care

Qualifikationen

• RN with 4–6 years of related nursing care coordination experience.
• Experience with Medicaid/STAR/CHIP is a plus.
• Strong clinical documentation and communication skills.
• Ability to manage care plans and coordinate with families and providers.

Aufgaben

• Develops and updates care plans with providers to meet member needs.
• Coordinates between members, families, and care teams for service delivery.
• Educates members and families on services and benefits.
• Reviews referrals and assessments to create appropriate care plans.
• Precepts clinical new hires and supports onboarding.

Kenntnisse

Clinical nursing

Communication skills

Documentation

Problem-solving

Attention to detail

Time management

Ausbildung

Bachelor's degree in Nursing

RN license

Tools

Electronic health records (EHR)

Jobbeschreibung

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 Senior Care Manager RN role supports members with physical health conditions, preventive care needs, and chronic disease management, such as asthma, diabetes, hypertension, high cholesterol, respiratory illnesses, or stress-related conditions. Knowledge and experience working with state-government sponsored programs (Medicaid, STAR CHIP) a PLUS. The standard schedule is Monday through Friday, 8:00 a.m. to 5:00 p.m.(CST)

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 needsCoordinates 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 servicesMonitors 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 needsMay identify problems/barriers for care management and appropriate care management interventions for escalated casesReviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulationsReviews referrals information and intake assessments to develop appropriate care plans/service plansMay perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resourcesCollaborates with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if neededCollects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulatorsProvides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefitsPartners with leadership team to improve and enhance care and quality delivery for members in a cost-effective mannerMay 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 practiceEngages and assists New Hire/Preceptee during onboarding journey including responsibility for completing competency check points ensuring readiness for Service Coordination successEngages in a collaborative and ongoing process with People Leaders and cross functional teams to measure and monitor readinessOther duties or responsibilities as assigned by people leader to meet business needsPerforms 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.Preferred Experience:7+ years of clinical nursing RN experience with direct patient care, clinical assessment, person-centered care planning, member outreach, care transitions, access to care, family & patient education, and ongoing service coordination for members (ages: 0- 65), but primarily with the adult population.Strong clinical documentation, problem-solving, communication, attention to detail, organization/time management skills, and works well under quick TAT times and deadlines are required.Ability to adapt to changing business needs with openness, flexibility, and professionalism.License/Certification:RN - Registered Nurse - State Licensure and/or Compact State Licensure requiredPay Range: $75,300.00 - $135,400.00 per year

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.

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.

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