You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
As the Care Manager for all Clinical and Care Management, you are saddled with the responsibility of developing, assessing, and facilitating complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families.
And to successfully apply for the Care Manager Role, you must:
1. Reside in New Jersey
2. 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.
3. Develop ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member’s unmet needs.
4. Identify problems/barriers to care and provide appropriate care management interventions.
5. 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.
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6. 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.
7. 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.
8. Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services.
9. Perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources as well as collect, document, and maintain all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
10. Provide and/or facilitate education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits as well as provide feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner.
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Additionally, qualified applicants must hold a Degree from an Accredited School of Nursing or a Bachelor’s degree in Nursing with 2 – 4 years of related experience and must be licensed/certified to work as a Registered Nurse under RN – Registered Nurse – State Licensure and/or Compact State Licensure because the Care Manager role is very competitive with mouthwatering salary ranging from $54,000 to $97,100 yearly with other benefits such as health insurance, living allowance, paid holidays and leave allowances as well as opportunity for career and personal development.
Application Deadline Not Specified as offer remains open until filled.