Senior Care Manager
1 month ago
Centene Corporation is seeking a highly skilled Senior Care Manager to join our team. As a Senior Care Manager, you will play a critical role in assessing, planning, and implementing complex care management activities to enable quality, cost-effective healthcare outcomes.
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.
- 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.
Centene Corporation 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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