Care Manager I (RN)

Description:

Position Purpose\: 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 careDevelop, assess and adjust, as necessary, the care plan and promote desired outcomeAssess the member’s current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider optionsCoordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clientsDevelop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member’s needsProvide patient and provider educationFacilitate member access to community based servicesMonitor referrals made to community based organizations, medical care and other services to support the membersa overall care management planActively participate in integrated team care management roundsIdentify related risk management quality concerns and report these scenarios to the appropriate resourcesEnter and maintain assessments, authorizations, and pertinent clinical information into various medical management systemsFor LTSS – 30% travel to perform home visits to membersFor New Hampshire, Massachusetts, & Michigan Complete Health – home visits required

Qualification:

Education/Experience\: Graduate from an Accredited School of Nursing. Bachelora s degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred.Licenses/Certifications\: Current statea s RN license..Office based

*TelephonicCentene 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.