Care Manager (RN) - Case Management
Company: Centene Corporation
Posted on: January 27, 2023
Care Manager (RN)You could be the one who changes everything for
our 26 million members as a clinical professional on our Medical
Management/Health Services team. Centene is a diversified, national
organization offering competitive benefits including a fresh
perspective on workplace flexibility.
Position Purpose: 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 options
* Utilize 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
* Coordinate services between Primary Care Physician (PCP),
specialists, medical providers, and non-medical staff as necessary
to meet the complete medical socio economic needs of clients
* Provide patient and provider education
* Facilitate member access to community based services
* Monitor referrals made to community based organizations, medical
care and other services to support the members' overall care
* Actively participate in integrated team care management
* Identify 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 commensurate with experience
* Enter and maintain assessments, authorizations, and pertinent
clinical information into various medical management systems
* Direct care to participating network providers
* Perform 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 needed
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.
Our Comprehensive Benefits Package: Flexible work solutions
including remote options, hybrid work schedules and dress
flexibility, Competitive pay, Paid time off including holidays,
Health insurance coverage for you and your dependents, 401(k) and
stock purchase plans, Tuition reimbursement and best-in-class
training and development.
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: Centene Corporation, McAllen , Care Manager (RN) - Case Management, Healthcare , Mcallen, Texas
Didn't find what you're looking for? Search again!