Transition of Care - RN Care Manager

Centene Management Company LLC; Kentucky; Hybrid; USD 56,000 - 101,000; Full time

Job summary

Centene Management Company LLC is seeking a remote Transition of Care Case Manager for the Kentucky market. The role focuses on complex care management for physically oriented members, developing personalized care plans and educating families for better outcomes.

Requires an active Kentucky State or Compact RN license and 2-4 years of related experience in medical-surgical, home health, or care management. Schedule is Mon-Fri, 8-5 CT or ET, with preference for Kentucky residents.

Qualifications

• Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2-4 years of related experience.

Responsibilities

• Evaluates member needs and barriers to accessing care, focusing on priorities to inform care plans.
• Develops ongoing care plans and collaborates with providers to identify resources.
• Coordinates between members, families, and care teams to ensure person-centered care.
• Provides follow-up and monitors progress toward care goals and revises plans as needed.
• Offers education to members and families on disease processes and care options.

Education

Degree in Nursing or BSN

Job description

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.

Responsibilities

• 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

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

About Centene

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

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

Commitment to Health

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.