Care Manager
1 week ago
Join Centene Corporation, a leading healthcare company, as a Care Manager and make a meaningful difference in the lives of our 28 million members. As a Care Manager, you will play a vital role in transforming the health of our communities, one person at a time.
About the Role:As a Care Manager, you will be responsible for developing, assessing, and facilitating complex care management activities for primarily physical needs members. Your primary goal will be to provide high-quality, cost-effective healthcare outcomes, including personalized care plans and education for members and their families.
Key Responsibilities:- Evaluate the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome.
- Develop ongoing care plans / service plans and collaborate with providers to identify providers, specialists, and/or community resources to address member's unmet needs.
- Identify problems/barriers to care and provide appropriate care management interventions.
- Coordinate 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.
- Provide ongoing follow-up and monitoring of 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.
- Provide resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate.
- Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services.
- May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources.
- 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.
- Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner.
Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 – 4 years of related experience.
RN - Registered Nurse - State Licensure and/or Compact State Licensure required.
What We Offer: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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