Nurse Specialist
2 weeks ago
Clinical Professional Opportunity with Centene Corporation
You could be the one who changes lives for our members as a clinical professional on our Medical Management/Health Services team. We offer a fresh perspective on workplace flexibility and a comprehensive benefits package.
- Key Responsibilities:
- Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development.
- Monitor delivery of services and follow-up with members, caregivers, or providers through in person visits and telephonic contact.
- Authorize and coordinate referral for services.
- Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care.
- Assist in coordinating the development of informal or voluntary services to integrate into the member care plan.
- Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long term care services.
- Assist member with filing and resolving complaints and appeals.
- Direct care to participating network providers.
- Participate in care management committees and work on special projects related to care management as needed.
Requirements:
Education/Experience: 3+ years of care management experience preferred, Home health, discharge planning, or long term care experience preferred.
Licenses/Certifications: Valid driver's license. NYS RN license required.
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.
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