Manager, CM – RN

Job not on LinkedIn

🕒 August 18

🏄 California – Remote

🏄 California – Remote

💵 $102.9k - $190.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 24%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Manage the care management team and care management of members to develop and assess high quality, cost-effective healthcare outcomes • Manage escalations and care management issues related to members or providers • Oversee and review care management documentation for compliance with federal and state regulations and contractual agreements • Develop and implement care management policies and procedures based on regulatory requirements and industry standards • Direct daily activities of care management staff, including reviewing and approving caseloads • Manage escalations and complex cases and guide team members in addressing member needs • Coordinate resolutions of member escalations and complaints and assist with audits and evaluations • Develop, implement, and oversee care management programs • Conduct telephonic, digital, home, and other site outreach to assess member needs • Set team goals and objectives and oversee care management data and reporting metrics • Monitor care management audits for compliance with federal, state, and NCQA standards • Provide feedback to improve member and provider experience and quality of care • Educate and provide resources to the care management team on key initiatives and member outreach • Assist senior leadership with onboarding, hiring, and training team members • Lead and champion change within scope of responsibility • Perform other assigned duties and comply with policies and standards

🎯 Requirements

• RN license for state of California required • Graduate from an Accredited School of Nursing or a Bachelor's degree and 5+ years of related experience • RN - Registered Nurse - State Licensure and/or Compact State Licensure required • Must be licensed in California • Prefer UM and CM experience • Will work PST hours

🏖️ Benefits

• Health insurance • 401K plan • 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 • Equal opportunity employer committed to diversity