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Care Manager RN - Remote Texas

Company: Superior HealthPlan
Location: San Juan
Posted on: January 11, 2022

Job Description:

You could be the one who changes everything for our 25 million members as a Care Manager on the Clinical team. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national Fortune 24 and rapidly growing organization, exceptional talent fuels our mission.Do you thrive in a supportive, result-oriented community and are committed to the relentless pursuit of continuous growth? As part of our clinical group, the member-focused care you deliver will make a difference and change the face of healthcare for [state]. Are you ready to make an impact?-- -As a Care Manager, you will:Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.-- -Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider optionsUtilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomesCoordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clientsProvide patient and provider educationFacilitate member access to community based servicesMonitor referrals made to community based organizations, medical care and other services to support the members' overall care management planActively participate in integrated team care management roundsIdentify related risk management quality concerns and report these scenarios to the appropriate resources.Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experienceEnter and maintain assessments, authorizations, and pertinent clinical information into various medical management systemsDirect care to participating network providersPerform duties independently, demonstrating advanced understanding of complex care management principles.Participate in case management committees and work on special projects related to case management as neededTravel is requiredOur Comprehensive Benefits Package:Flexible work solutions including remote options, hybrid work schedules and dress flexibilityCompetitive payPaid Time Off including paid holidaysHealth insurance coverage for you and dependents401(k) and stock purchase plansTuition reimbursement and best-in-class training and developmentIn-person and virtual training following State and Community guidelines-- -Education/Experience: Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of clinical nursing or case management experience in a clinical, acute care, managed care or community setting. 2+ years experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs. Other state specific requirements may apply.Licenses/Certifications: Current state's RN license.Superior Health Plan (TEXAS Only)Licenses/Certifications: Current state's RN license is applicable to-- -TEXAS and driver's license is required.SUPERIOR HEALTH STAR KIDS - CASE MGTSeeking RN candidates with 2+ years of Pediatrics clinical nursing experience to service pediatric members.-- -Once we are authorized to resume in-person member visits, this-- -Field Care Manager position works remotely from home and travels to conduct member assessments.Preferred Experience:-- -2+ years of clinical nursing experience supporting pediatric populations with complex medical needs (i.e., acute care, Peds ER, CICU, NICU, PICU, home health, community clinics, and school-based settings).-- - Managed care experience is preferred.NOTE: This is a FIELD/REMOTE position IN STATE.-- - Seeking RN candidates in any of the following TEXAS-- -locations: Alamo, Brownsville, Donna, Laredo, McAllen,-- -Mission, Mercedes, Pharr, Progeso, Santa Rosa, or Weslaco,TX.-- - Travel is required-- -once we are authorized to safely travel and conduct member assessments in-person, post COVID restrictions. Mileage Reimbursement is available for travel.-- -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.

Keywords: Superior HealthPlan, McAllen , Care Manager RN - Remote Texas, Executive , San Juan, Texas

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