Senior Care Manager, RN

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🔥 13 horas atrás

🌲 North Carolina – Remoto

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💵 $75.300 - $135.400 / ano

⏰ Tempo Integral

🟠 Sênior

👔 Gerente

👻 Score fantasma 0%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of Centene Corporation

Centene Corporation

10.000+ funcionários

Fundada em 1984

🛡️ Seguros

💼 Consultoria

🏥 Saúde

Insurance • Consulting • Healthcare

Centene Corporation é uma provedora líder de serviços de saúde patrocinados pelo governo, especializada em oferecer soluções de saúde acessíveis e de alta qualidade. Há mais de 40 anos, a Centene tem se dedicado a transformar a saúde das comunidades, ampliando o acesso a Medicaid, Medicare e ao Health Insurance Marketplace, além de atender comunidades militares por meio do programa TRICARE. Como a maior organização de managed care do Medicaid e participante-chave no Marketplace, a Centene enfatiza a entrega de cuidados de saúde com foco local, combinada a parcerias sólidas com organizações sem fins lucrativos para atender às necessidades únicas de seus membros. A Centene também é comprometida com sustentabilidade corporativa e responsabilidade social, priorizando a gestão ambiental e a governança ética para promover o bem-estar das comunidades que atende.

Descrição

• Support high-risk members through assessments, individualized care planning, outreach, and complex caseload management • Assist with case setup and backup training • Assess, plan, and implement complex care management activities to enable quality, cost-effective healthcare outcomes • Develop personalized care plans/service plans and address members’ unmet needs • Educate members and families/caregivers on disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits • Continuously assess care plans and collaborate with providers to identify specialists and community resources • Coordinate between members/families/caregivers and care provider teams to ensure adequate, appropriate person-centered care • Monitor member status, changes in condition, progress, and care plan goals; revise plans as needed • Identify problems, barriers, and interventions for escalated cases • Review member data, referrals, and intake assessments to improve operating performance, quality care, and care planning • Perform telephonic, digital, home, and/or other site outreach • Collaborate with healthcare providers to facilitate services/treatments and revise care plans • Collect, document, and maintain member information and care management activities for regulatory compliance • Partner with leadership to improve cost-effective care and quality delivery • Precept clinical new hires, foster core skills, coach growth, and guide onboarding • Provide guidance, support, coaching, and shadowing to clinical new hires/preceptees in an MCO • Complete competency checkpoints and assess readiness for Service Coordination success • Collaborate with People Leaders and cross-functional teams to measure and monitor readiness • Perform other duties as assigned and comply with all policies and standards

🎯 Requisitos

• Candidates must reside in North Carolina • NC RN license required • RN - Registered Nurse - State Licensure and/or Compact State Licensure required • Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing • 4–6 years of related experience • Monday–Friday, 8:00 a.m.–5:00 p.m. schedule, with flexibility available after training • Knowledge/experience in care management • Ability to assess high-risk members and manage complex caseloads • Ability to develop and maintain individualized care plans/service plans • Ability to collaborate with members, caregivers, providers, specialists, community resources, leadership, and cross-functional teams • Ability to document member information and care management activities in compliance with state, federal, and third-party payer regulations

🏖️ Benefícios

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules • additional forms of incentives may be included in total compensation • diversity-focused equal opportunity employer

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