Pediatric RN, Care Manager

16 hours ago

AUSTIN, United States Superior HealthPlan Full time

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Work Location: Austin, TX Full-time Position: Care Manager, Pediatric RN

Position Purpose: Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health needs to promote quality, cost effective care. Develops a personalized care plan / service plan for long-term care members, addresses issues, and educates members and their families/caregivers on services and benefit options available to receive appropriate high-quality care.

  • Evaluates the service needs of the most complex or high risk/high acuity members and recommends a plan for the best outcome

  • Develops and continuously assesses ongoing long-term care plans / service plans and collaborates with care management team to identify providers, specialists, and/or community resources needed to address member's needs

  • Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services

  • Monitors care plans / service plans and/or member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / needs

  • Monitors member status for complications and clinical symptoms or other status changes, including assessment needs for potential entry into a higher level of care and/or waiver eligibility, as applicable

  • Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations

  • Reviews referrals information and intake assessments to develop appropriate care plans / service plans

  • Collaborates with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed

  • Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and clinical guidelines

  • Provides and/or facilitates education to long-term care members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits

  • Acts as liaison and member advocate between the member/family, physician, and facilities/agencies

  • Educates on and coordinates community resources. Provides coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living)

  • May perform home and/or other site visits (e.g., once a month or more), such as to assess member needs and collaborate with resources, as required

  • Partners with leadership team to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner

  • May precept clinical new hires by fostering and building core skills, coaching and facilitating their growth, and guiding through the onboarding process to upskill readiness

  • May provide guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities to bridge gap between classroom training and field practice

  • May engage and assist New Hire/Preceptee during onboarding journey including responsibility for completing competency check points ensuring readiness for Service Coordination success

  • Engages in a collaborative and ongoing process with People Leaders and cross functional teams to measure and monitor readiness

  • Performs other duties as assigned

  • Complies with all policies and standards

  • Travel is required for home visits

Education/Experience: Requires Graduate from an Accredited School of Nursing or a Bachelor's degree and 4–6 years of related experience. Bachelor's degree in Nursing preferred

License/Certification:

  • RN - Registered Nurse - State Licensure or Compact Licensure for Texas required

Preferred Experience:

  • Clinical RN nursing experience with direct patient care and/or administering medically approved Medicaid assessment and providing case management and coordinating referrals for medical services

  • Pediatrics, NICU, PICU, Pediatric ER

  • Pediatric Home Health or Private Duty Nurse

  • School Nurse

  • Case Management

  • Service Coordination

  • LTSS Care Coordination

  • Community health settings

  • Managed Care

Pay Range: $35.49 - $63.79 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

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.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

  • RN, Care Manager

    1 week ago

    Austin, United States Superior HealthPlan Full time

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Case Manager - Pediatric RN conducts pediatric health assessments...

  • RN, Care Manager

    1 week ago

    Austin, United States Superior HealthPlan Full time

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Case Manager - Pediatric RN conducts pediatric health assessments...

  • Pediatric Care Manager

    6 days ago

    Austin, Texas, United States Superior HealthPlan Full time

    Transforming HealthcareAs a Pediatric Care Manager at Superior HealthPlan, you have the opportunity to make a profound impact on the lives of our pediatric members. Our organization is dedicated to delivering exceptional healthcare services, and we're seeking an experienced RN with a passion for pediatric care management.This role involves conducting home...

  • RN, Care Manager

    23 hours ago

    Austin, United States Superior HealthPlan Full time

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, youll have access to competitive benefits including a fresh perspective on workplace flexibility. Case Manager - Pediatric RN conducts pediatric health assessments with...

  • Pediatric RN, Care Manager

    4 days ago

    AUSTIN, United States Superior HealthPlan Full time

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. RN Care Manager, PediatricsWork Location: Austin, TXPediatric RN...

  • Pediatric RN, Care Manager

    3 days ago

    Austin, United States Superior HealthPlan Full time

    Job DescriptionYou could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.RN Care Manager, PediatricsWork Location: Austin,...

  • Pediatric RN, Care Manager

    3 days ago

    Austin, United States Superior HealthPlan Full time

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. RN Care Manager, PediatricsWork Location: Austin, TXPediatric RN...

  • Pediatric RN, Care Manager

    22 hours ago

    Austin, United States Superior HealthPlan Full time

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, youll have access to competitive benefits including a fresh perspective on workplace flexibility. RN Care Manager, PediatricsWork Location: Austin, TXPediatric RN...

  • RN, Care Manager, Pediatrics

    1 week ago

    Austin, United States Superior HealthPlan Full time

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Work Location: Austin, TX. Pediatric Nursing is required for this...

  • RN Care Manager Pediatric Position

    3 days ago

    Austin, Texas, United States Superior HealthPlan Full time

    Pediatric RN Care Manager Job SummaryAs a Pediatric RN Care Manager at Superior HealthPlan, you will play a critical role in transforming the lives of our 28 million members. With a strong background in pediatric nursing and care coordination, you will be responsible for assessing and managing the care of complex populations.Your expertise will be invaluable...

  • Care Manager for Pediatric Patients

    6 days ago

    Austin, Texas, United States Centene Corporation Full time

    Pediatric RN Medical Case Manager Job TitleAs a Pediatric RN Medical Case Manager, you will play a critical role in ensuring that our pediatric patients receive high-quality, coordinated care. This is an excellent opportunity to join our team and make a meaningful difference in the lives of our patients.Key Responsibilities:Conduct thorough assessments of...

  • Pediatric RN, Care Manager

    2 days ago

    Austin, United States Superior HealthPlan Full time

    Job DescriptionYou could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.Work Location: Austin, TX Full-time Position: Care...

  • Pediatric RN, Care Manager

    23 hours ago

    Austin, United States Superior HealthPlan Full time

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, youll have access to competitive benefits including a fresh perspective on workplace flexibility. Work Location: Austin, TX Full-time Position: Care Manager, Pediatric...

  • RN, Care Manager, Pediatrics

    1 week ago

    Austin, United States Superior HealthPlan Full time

    Job DescriptionYou could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.Work Location: Austin, TX. Pediatric Nursing is...

  • RN Care Manager, Pediatrics

    3 days ago

    Austin, United States Superior HealthPlan Full time

    Job DescriptionYou could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.Pediatric RN - local travel in Austin, TX is required...

  • RN Care Manager, Pediatrics

    14 hours ago

    AUSTIN, United States Superior HealthPlan Full time

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Pediatric RN - local travel in Austin, TX is required for member...

  • RN Care Manager, Pediatrics

    23 hours ago

    Austin, United States Superior HealthPlan Full time

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, youll have access to competitive benefits including a fresh perspective on workplace flexibility. Pediatric RN - local travel in Austin, TX is required for member visits...

  • RN Pediatric Critical Care Unit Manager

    7 days ago

    Austin, Texas, United States Ascension Full time

    Job SummaryWe are seeking an experienced RN-Pediatric Critical Care Unit Manager to join our team at Dell Children's Medical Center in Austin, Texas.

  • Pediatric Case Manager RN

    3 days ago

    Austin, Texas, United States OneStaff Medical Full time

    As a skilled Pediatric Case Manager RN, you will play a crucial role in coordinating long-term care for patients. This position involves working with specific groups of patients, such as those with diseases like HIV/AIDS or cancer, or focusing on age groups like geriatrics or pediatrics.You will research the latest treatment and procedures, work with...

  • Travel Pediatric Critical Care RN

    23 hours ago

    Austin, Texas, United States Supplemental Health Care Full time

    Pediatric ICU Nursing Job DescriptionThis role requires a skilled and compassionate Pediatric ICU Registered Nurse to join our team for a 13-week assignment in Austin, Texas. The successful candidate will have a minimum of 1-2 years of recent experience working in CVICU Pediatrics and hold a current Texas RN license/certification. Additional requirements...