Senior Care Manager, RN – STAR/CHIP

🔥 0 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $75.3k - $135.4k / year

⏰ Full Time

🟠 Senior

👔 Manager

👻 Ghost score 0%

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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

• Assess, plan, and implement complex care management activities to enable quality, cost-effective healthcare outcomes • Develop personalized care plans/service plans for care members • Address member issues and educate members and families/caregivers on services and benefit options • Continuously assess care plans and collaborate with providers, specialists, and community resources • Coordinate between members/families/caregivers and care provider teams to ensure appropriate person-centered care • Monitor member status, changes in condition, and progress toward care plan goals; revise plans as needed • Identify problems and barriers and recommend care management interventions for escalated cases • Review member data, referrals, and intake assessments to improve quality and develop appropriate care plans • Perform telephonic, digital, home, and/or other site outreach to assess member needs • 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 • Provide or facilitate education on disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits • Partner with leadership to improve care and quality delivery cost-effectively • May precept clinical new hires and provide coaching, shadowing, onboarding, and competency support • Engage with People Leaders and cross-functional teams to measure and monitor new-hire readiness • Perform other assigned duties and comply with all policies and standards

🎯 Requirements

• Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing • 4–6 years of related experience • RN - Registered Nurse - State Licensure and/or Compact State Licensure required • 7+ years of clinical nursing RN experience with direct patient care, clinical assessment, person-centered care planning, member outreach, care transitions, access to care, family & patient education, and ongoing service coordination preferred • Experience primarily with the adult population, serving members ages 0–65 • Strong clinical documentation, problem-solving, communication, attention to detail, organization/time management skills • Ability to work under quick TAT times and deadlines • Ability to adapt to changing business needs with openness, flexibility, and professionalism • Knowledge and experience working with state-government sponsored programs (Medicaid, STAR CHIP) is a plus • Availability for Monday through Friday, 8:00 a.m. to 5:00 p.m. CST

🏖️ Benefits

• Competitive pay • Health insurance • 401K • 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