Care Manager (RN)

Job Overview Position serves the NH Health Families Medicaid population. NH RN Licensure is required. Experience in both Physical Health and Behavioral Health is highly preferred. 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. Responsibilities Evaluate the needs of the member, barriers to accessing appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommend or facilitate a plan for the best outcome. Develop ongoing care plans/service plans and collaborate with providers to identify specialists and/or community resources to address members’ unmet needs. Identify problems/barriers to care and provide appropriate care management interventions. Coordinate between the member and/or family/caregivers and the care provider team to ensure members receive adequate and appropriate person‑centered care or services. 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 providers to revise or update plans as necessary to meet goals and unmet needs. Provide resource support to members and care managers for local services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans. Facilitate care management and collaborate with providers or specialists to ensure members have 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. Collect, document, and maintain all member information and care management activities to ensure compliance with state, federal, and third‑party payer regulations. Provide and/or facilitate education to members and families/caregivers on disease processes, resolving care gaps, provider instructions, care options, referrals, and benefits. Provide 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; perform additional duties as assigned. Comply with all policies and standards. Education and Experience Requires a degree from an accredited school of nursing or a Bachelor’s degree in nursing and 2–4 years of related experience. License/Certification RN – Registered Nurse – State Licensure and/or Compact State Licensure required. Pay & Benefits Pay range: $56,200.00 – $101,000.00 per year. 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 schedules. EEO Statement 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. #J-18808-Ljbffr