Care Manager (RN) - Morris, Warren, and/or Sussex County
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.
Must reside in New Jersey for home visits within Morris, Warren, or Sussex County. Travel up to 75% required.
Position Purpose: Develops, assesses, and facilitates 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.
- Evaluates 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
- Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs
- Identifies problems/barriers to care and provide appropriate care management interventions
- Coordinates 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
- Provides 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
- Provides 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
- Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services
- May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
- Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
- Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits
- Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
- Other duties or responsibilities as assigned by people leader to meet business needs
- Performs other duties as assigned
- Complies with all policies and standards
License/Certification:
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
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As a Care Manager (RN) with Centene, you have the opportunity to make a genuine difference in the lives of our 28 million members. We are on a mission to transform community health, one person at a time, and we believe you could be the catalyst for that change. This remote position, based in New Jersey, primarily focuses on Morris, Warren, and Sussex Counties, with travel requirements of up to 75%. You'll develop, assess, and facilitate complex care management activities tailored to the physical needs of our members, providing high-quality and cost-effective healthcare outcomes. Your task will include crafting personalized care plans while collaborating with various providers and community resources to address the varied needs of our members. You’ll also play a critical role in problem-solving, helping members overcome barriers to care and ensuring that they receive the appropriate, person-centered services they deserve. With ongoing support and monitoring of member status, you'll adapt care plans as necessary, always striving toward achieving their health goals. Additionally, this position involves educating members and their families on critical health processes and resources, promoting self-management and successful outcomes. With competitive pay, a robust benefits package, and a culture of empathy and understanding, Centene values your skills and insights as we look to enhance our healthcare delivery. Join us, and help us change the future of health together!
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Transforming the health of the community, one person at a time.
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