Care Manager
1 month ago
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 LTSS Services RN position - Superior Health Plan STAR Kids services pediatric members in the Austin/ Travis County, TX.
Travel is required for member visits 3 days per week.
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 member 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 and/or Compact State Licensure required or
- NP - Nurse Practitioner - Current State's Nurse Licensure required
- For Superior: Resource Utilization Group (RUG) certification must be obtained within 90 days of hire 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
Pediatrics PDN
School Nurse
Home Health or Hospice experience
Case Management
Service Coordination for medical services
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
-
Care Management Professional
3 weeks ago
Austin, Texas, United States ComForCare Home Health Care - Texas Hill Country Full timeAbout UsComForCare Home Health Care - Texas Hill Country is a rapidly growing agency dedicated to providing high-quality home care services to our clients.Job DescriptionWe are seeking a skilled Business Development professional to join our team. This is an excellent opportunity for someone looking to start their career in management or business...
-
Clinical Care Manager
1 week ago
Austin, Texas, United States Res-Care, Inc Full timeAbout the Role:We are recruiting a motivated and empathetic Registered Nurse to join our community living services team at ResCare Community Living. In this critical role, you will provide hands-on nursing care and support to individuals with various needs, ensuring their comfort, safety, and overall well-being.Key Responsibilities:Evaluate health concerns...
-
Austin, United States Res-Care, Inc Full timeRN / Registered Nurse Case ManagerOur Company Embrace Hospice & Home Health Overview Our Hospice Registered Nurse (RN) Case Managers are the heart of our organization! In this role, you will support your patients by providing direct care and coordinating with the interdisciplinary team to ensure that both patients and their families have an optimal care...
-
RN / REGISTERED NURSE CASE MANAGER - Case Management
3 months ago
austin, United States Res-Care, Inc Full timeRN / REGISTERED NURSE CASE MANAGEROur Company Embrace Hospice & Home Health Overview Our Hospice Registered Nurse (RN) Case Managers are the heart of our organization! In this role, you will support your patients by providing direct care and coordinating with the interdisciplinary team to ensure that both patients and their families have an optimal care...
-
Continuity of Care Coordinator
3 months ago
Austin, United States Integral Care Full timeJob Number: 24-6698 Job Summary: This position works with Integral Care's ANEW Program at the clinic, providing continuity of care services to consumers who are re-integrating into the community after incarceration. Case Managers provide services to individuals diagnosed with severe mental illnesses who may also have co-occurring substance use disorders...
-
Care Manager
5 months ago
AUSTIN, United States Superior HealthPlan Full timeYou 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. Hybrid Position - Field visits and work remotely from homeMust reside...
-
Care Manager
3 hours ago
Austin, United States Superior HealthPlan Full timeJob 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.Hybrid Position - Field visits and work remotely from...
-
Pediatric Care Manager
1 week ago
Austin, Texas, United States Superior HealthPlan Full timePediatric Care ManagerEstimated Salary: $34.81 - $62.54 per hourWe are seeking a highly skilled Pediatric Care Manager to join our team at Superior HealthPlan. As a Pediatric Care Manager, you will play a vital role in assessing and coordinating medical and supporting services for complex pediatric populations.Key Responsibilities:Evaluate service needs of...
-
Pediatric Care Manager
1 week ago
Austin, Texas, United States Superior HealthPlan Full timeJob Title: Pediatric Care ManagerWe are seeking a skilled and compassionate Pediatric Care Manager to join our team at Superior HealthPlan. As a key member of our care management team, you will play a vital role in providing high-quality, patient-centered care to our pediatric members.About the Role:Assess and coordinate medical and supportive services...
-
Nurse Care Manager
3 weeks ago
Austin, Texas, United States Healix Full timeAre you a licensed nurse with a passion for delivering high-quality patient care? Do you have experience working in a fast-paced clinical setting? If so, we encourage you to apply for the Nurse Care Manager role at Healix in Austin, TX.About the Job:This is a full-time position that requires strong leadership and communication skills to manage onsite nursing...
-
Pain Management Physician
1 week ago
Austin, Texas, United States Advanced Pain Care Full timeWork at Advanced Pain CareA Career OverviewWe are dedicated to managing pain through interdisciplinary approaches. As a Pain Management Physician, you will play a crucial role in our mission.Salary InformationThe annual salary for this position is approximately $285,000, featuring a competitive benefits package including partial employer-paid insurance and...
-
Medical Office Manager
12 hours ago
Austin, United States PAIN CARE PHYSICANS PA Full timeBenefits: 401(k) 401(k) matching Competitive salary Dental insurance Employee discounts Health insurance Opportunity for advancement Paid time off Training & development Vision insurance Wellness resources Pain Care Physicians (PCP) is a leading specialty medical practice dedicated to providing comprehensive and compassionate care to patients with chronic...
-
Administrative Care Manager
1 week ago
Austin, Texas, United States Centene Corporation Full timeJob SummaryWe're seeking a skilled Administrative Care Manager to support our administrative care management activities. In this role, you'll perform outreach, answer inbound calls, and schedule services while serving as a point of contact to members, providers, and staff.
-
Continuity of Care Coordinator
1 month ago
Austin, United States Integral Care Full timeJob Number: 24-12387 Job Summary: Position functions as the Continuity of Care Coordinator with the local State Mental Health Facility (SMHF) through the Utilization Management department of the Network Development and Management division of Integral Care, the Local Mental Health Authority (LMHA) for Travis County. The purpose of the position is to perform...
-
Austin, TX, United States Providence Health Care Staffing Full timeProvidence Health Care Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Austin, Texas. Job Description & Requirements ~ Specialty: Case Management ~ Discipline: RN ~ Start Date: ASAP ~ Duration: 13 weeks ~36 hours per week ~ Shift: 12 hours, days ~ Employment Type: Travel Providence Health Care Staffing Job ID...
-
Travel Registered Nurse RN Care Management
3 days ago
Austin, TX, United States Providence Health Care Staffing Full timeProvidence Health Care Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Austin, Texas. Job Description & Requirements ~ Specialty: Case Management ~ Discipline: RN ~ Start Date: ASAP ~ Duration: 13 weeks ~36 hours per week ~ Shift: 12 hours, days ~ Employment Type: Travel Providence Health Care Staffing Job ID...
-
Care Management Coordinator
1 week ago
Austin, Texas, United States Centene Corporation Full timeTransforming Healthcare OutcomesCentene Corporation is seeking a highly skilled Care Management Coordinator to join our team. As a key member of our care management team, you will be responsible for developing and implementing personalized care plans that meet the unique needs of our long-term care members.About the RoleIn this critical role, you will work...
-
Dialysis Operations Manager RN Leader
3 weeks ago
Austin, Texas, United States Fresenius Medical Care Full timeAbout the RoleAs a Clinical Manager at Fresenius Medical Care, you will be responsible for overseeing the daily operations of our dialysis clinics. This is a leadership role that requires strong clinical expertise and exceptional management skills.About the Job DescriptionWe are seeking an experienced Registered Nurse with at least 6 years of business...
-
Care Management Professional
1 week ago
Austin, Texas, United States Superior HealthPlan Full time**Job Overview**We are seeking a skilled Care Manager to join our team at Superior HealthPlan. As a Care Manager, you will play a critical role in transforming the health of our communities, one person at a time.With your expertise in behavioral health and social work, you will be responsible for developing, assessing, and facilitating complex care...
-
Clinical Medical Care Specialist
2 weeks ago
Austin, Texas, United States Integral Care Full timeClinical Medical Care Specialist Position:At Integral Care, we are seeking a talented Clinical Medical Care Specialist to join our team. As an Advanced Practice Nurse-Psychiatric Mental Health or Physician Assistant, you will be responsible for providing high-quality medical services under the supervision of a licensed physician in a community mental health...
