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Care Manager for Long-Term Services and Supports
2 months ago
We are seeking a skilled Care Manager to join our team at Centene Corporation. As a Care Manager, you will play a critical role in assessing and coordinating medical and supporting services for complex/high acuity populations.
Key Responsibilities- Develop and implement personalized care plans to promote quality, cost-effective care for long-term care members.
- Evaluate the service needs of high-risk members and recommend plans for optimal outcomes.
- Collaborate with care management teams to identify providers, specialists, and community resources needed to address member needs.
- Coordinate and manage care plans, ensuring members receive adequate and appropriate person-centered care or services.
- Monitor member status, change in condition, and progress towards care plan goals, revising or updating plans as necessary.
- Review member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations.
- Collaborate with healthcare providers to facilitate member services and determine revised care plans if needed.
- Collect, document, and maintain all member information and care management activities to ensure compliance with current state, federal, and clinical guidelines.
- Provide 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.
- Act as liaison and member advocate between the member/family, physician, and facilities/agencies.
- Educate on and coordinate community resources, providing coordination of service authorization to members and care managers for various services based on service assessment and plans.
- Graduate from an Accredited School of Nursing or a Bachelor's degree and 4–6 years of related experience.
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required or NP - Nurse Practitioner - Current State's Nurse Licensure required.
- Resource Utilization Group (RUG) certification must be obtained within 90 days of hire required.
- Competitive pay: $62.54 per hour.
- Comprehensive benefits package, including 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.
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.
