Long Term Care Nurse Specialist

4 weeks ago


Brooklyn, New York, United States Centene Corporation Full time
Job Summary:

As a Long Term Care Nurse Specialist on our Medical Management/Health Services team, you will play a critical role in changing the lives of our 28 million members. We offer a fresh perspective on workplace flexibility and 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.

Key Responsibilities:

• Conduct 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 referrals 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 members 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:

• 3+ years of care management experience preferred, Home health, discharge planning, or long-term care experience preferred

• Valid driver's license

• NYS RN license required

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.

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