Transition of Care - RN Care Manager

WellCare of Kentucky; Kentucky; Remoto; USD 56.000 - 101.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health insurance

401K & stock purchase plans

Tuition reimbursement

Paid time off + holidays

Remote work options

Descrizione del lavoro

Centene, parent of WellCare of Kentucky, seeks an experienced RN for remote care management focused on transitions of care for Kentucky members. You will assess needs, create care plans, and coordinate with providers to ensure seamless, person-centered services.

Requires an active RN license (Kentucky or compact) and 2–4 years in medical-surgical or related settings. Schedule is Mon–Fri 8–5 CT/ET, with remote work options.

Competenze

• RN license required (Kentucky or compact state)
• Bachelor’s degree in Nursing or higher
• 2–4 years in medical-surgical or related care settings
• Experience with transitions of care is preferred
• Remote role serving Kentucky market

Mansioni

• Assess member needs, barriers to care, and social determinants of health.
• Develop ongoing care plans and coordinate with providers and services.
• Identify problems to address gaps in care and implement interventions.
• Coordinate with family/caregivers and care teams for appropriate services.
• Provide follow-up, monitor status, and revise care plans as needed.
• Offer resource support for local services (housing, employment, etc.).
• Facilitate timely access to needed care and services.
• Conduct telephonic/digital/home outreach as appropriate.
• Document all care management activities to ensure compliance.
• Educate members and families on disease processes and care options.
• Provide feedback to leadership on improvement opportunities.
• Perform other duties as assigned by leader.

Conoscenze

Nursing

Care management

Education delivery

Formazione

Bachelor's degree in Nursing

Degree from Accredited School of Nursing

Descrizione del lavoro

Position Purpose:

Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families.

Key Details:

This is a fully remote role that focuses on transitions of care case management for the Kentucky market. Preference will be given to applicants who (1) reside in Kentucky (first) or eastern or central time zone (secondly), (2) have an active Kentucky State or Compact RN license as well as (3) experience in medical-surgical or other inpatient units, or clinical outpatient settings such as home health, or care management. The schedule is Monday through Friday, 8-5 PM CT or ET.

• Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome
• Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs
• Identifies problems/barriers to care and provide appropriate care management interventions
• Coordinates 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
• Provides ongoing follow up and monitoring of 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
• Provides resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate
• Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services
• May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
• 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
• Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
• 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 of Nursing or a Bachelor's degree in Nursing and 2-4 years of related experience.

License/Certification:

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

Pay Range: $56,200.00 - $101,000.00 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