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Care Manager RN - Remote Texas

Company: Superior HealthPlan
Location: Missouri City
Posted on: January 11, 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 requiredOur Comprehensive Benefits Package:
    • Flexible work solutions including remote options, hybrid work schedules and dress flexibility
    • Competitive pay
    • Paid Time Off including paid holidays
    • Health insurance coverage for you and dependents
    • 401(k) and stock purchase plans
    • Tuition reimbursement and best-in-class training and development
    • In-person and virtual training following State and Community guidelinesAbout Centene:
      • We are an industry leader with a local focus and a global vision:
      • We are a diversified, multi-national, inclusive healthcare company delivering relevant, technology-driven solutions at the global, national, and local levels
      • Listed on Fortune magazines Worlds Most Admired Companies List for 2nd consecutive year
      • National footprint across all 50 states, serving 1 in 15 individuals in the U.S.
      • Recognized as one of the Best Places to Work by the Human Rights Campaign FoundationTexas Requirements:Education/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.Superior Health Plan (TEXAS Only)Licenses/Certifications: Current states RN license is applicable toTEXAS and driver's license is required.SUPERIOR HEALTH STAR KIDS CASE MGTSeeking RN candidates with 2+ years of Pediatrics clinical nursing experience to service pediatric members.Once we are authorized to resume in-person member visits, thisField Care Manager position works remotely from home and travels to conduct member assessments.Preferred Experience:2+ years of clinical nursing experience supporting pediatric populations with complex medical needs (i.e., acute care, Peds ER, CICU, NICU, PICU, home health, community clinics, and school-based settings). Managed care experience is preferred.NOTE: This is a FIELD/REMOTE position in Texas. Seeking RN candidates to conduct member assessments in the Houston, 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, Missouri City , Care Manager RN - Remote Texas, Healthcare , Missouri City, Texas

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