MissionRecruiter Since 2001
the smart solution for Mission jobs

Care Manager RN - Remote Texas

Company: Superior HealthPlan
Location: Delmita
Posted on: January 13, 2022

Job Description:

You could be the one who changes everything for our 25 million members as a Care Manager on the Clinical team. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national Fortune 24 and rapidly growing organization, exceptional talent fuels our mission.Do you thrive in a supportive, result-oriented community and are committed to the relentless pursuit of continuous growth? As part of our clinical group, the member-focused care you deliver will make a difference and change the face of healthcare for Texas. Are you ready to make an impact?As a Care Manager, you will:Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.

  • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
  • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
  • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
  • Provide patient and provider education
  • Facilitate member access to community based services
  • Monitor referrals made to community based organizations, medical care and other services to support the members overall care management plan
  • Actively participate in integrated team care management rounds
  • Identify related risk management quality concerns and report these scenarios to the appropriate resources.
  • Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • Direct care to participating network providers
  • Perform duties independently, demonstrating advanced understanding of complex care management principles.
  • Participate in case management committees and work on special projects related to case management as needed
  • Travel is requiredEducation/Experience: Graduate from an Accredited School of Nursing. Bachelors degree in Nursing preferred. 2+ years of clinical nursing or case management experience in a clinical, acute care, managed care or community setting. 2+ years experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs. Other state specific requirements may apply.Licenses/Certifications: Current states RN license and driver's license is required.NOTE: This is a FIELD/REMOTE position in Texas. Seeking RN candidates to conduct member assessments in the Hidalgo County - McAllen, TX area.Travel is requiredonce we are authorized to safely travel and conduct member assessments in-person, post COVID restrictions. Mileage Reimbursement is available for travel.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.

Keywords: Superior HealthPlan, Mission , Care Manager RN - Remote Texas, Executive , Delmita, Texas

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Log In or Create An Account

Get the latest Texas jobs by following @recnetTX on Twitter!

Mission RSS job feeds