Senior Care Manager (RN) at Centene

You're a Registered Nurse with 4–6 years of experience in care management. **What makes it worth a look...** Centene is offering a Senior Care Manager position

Work type: remote

Location: Remote-MI | Macomb-Michigan(48044)

Salary: $75,300 – $135,400/yr

Type: Full-time

Summary

You're a Registered Nurse with 4–6 years of experience in care management. **What makes it worth a look...** Centene is offering a Senior Care Manager position with a salary range of $75,300 - $135,400 per year. This role is fully remote, though it requires travel to members' homes in Wayne or Macomb County, Michigan, approximately 50-75% of the time. **You might be a good fit if you...** * Are a Registered Nurse (RN) with active state licensure. * Have experience developing personalized care plans. * Can assess member needs and collaborate with providers. * Are comfortable educating members and their families on services.

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 hybrid position requiring travel to members’ homes approximately 50-75% of the time, with the remaining time spent working remotely. The ideal candidate will reside in Wayne or Macomb County, Michigan.

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.

• 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

License/Certification:

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

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.

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