Senior Care Manager

4 weeks ago

Austin, Texas, United States Centene Corporation Full time
Job Title: Senior Care Manager

Join Centene Corporation, a leading healthcare company, as a Senior Care Manager. In this role, you will play a critical part in transforming the health of our communities, one person at a time.

Job Summary:

We are seeking a highly skilled and compassionate Senior Care Manager to join our team. As a Senior Care Manager, you will be responsible for assessing, planning, and implementing complex care management activities to enable quality, cost-effective healthcare outcomes. You will develop personalized care plans, address issues, and educate members and their families/caregivers on services and benefit options available to receive appropriate high-quality care.

Key Responsibilities:
  • Develop and continuously assess ongoing care plans/service plans and collaborate with providers to identify providers, specialists, and/or community resources needed to address member's unmet needs
  • Coordinate and manage 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
  • Monitor 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/unmet needs
  • May identify problems/barriers for care management and appropriate care management interventions for escalated cases
  • 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
  • May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
  • 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 third-party payer regulators
  • Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits
  • Partners with leadership team to improve and enhance care and quality delivery for 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
  • Provides 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
  • Engages and assists 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
  • Other duties or responsibilities as assigned by people leader to meet business needs
Requirements:
  • Requires a Degree from an Accredited School or Nursing or a Bachelor's degree in Nursing and 4 - 6 years of related experience
  • RN - Registered Nurse - State Licensure and/or Compact State Licensure required
  • For Illinois Youth Care Contract: Bachelor's degree in nursing required
Location:

Position is mainly remote. Prefer candidate to live in/around San Antonio or Austin, TX.

Pay Range:

$72,400.00 - $130,100.00 per year

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

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