Clinical Care Manager

3 weeks ago


New York, New York, United States DirectEmployers Full time
Care Management Opportunities

As a Clinical Care Manager - Long Term Care Specialist, you will play a vital role in our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits, including a fresh perspective on workplace flexibility.

Key Responsibilities:

• Conduct comprehensive assessments with members, caregivers, or providers to gather information on client status, support systems, and service needs for care plan development.

• Monitor the 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.

• Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plans, care plans, 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, with a focus on home health, discharge planning, or long-term care experience.

• Valid driver's license and NYS RN license.

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.
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