Care Manager, RN
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Job Description
Remote Care Manager RN coordinating physical and behavioral healthcare for New Hampshire Health Families Medicaid members. Developing care plans, connecting resources, and improving cost-effective outcomes at Centene.
Responsibilities:
- Develop, assess, and facilitate complex care management activities for members with primarily physical needs
- Evaluate member needs, barriers to care, and social determinants of health
- Develop ongoing care plans/service plans and collaborate with providers and community resources
- Identify problems and barriers to care and provide care management interventions
- Coordinate person-centered care among members, families/caregivers, and provider teams
- Follow up and monitor member status, condition changes, and progress toward care plan goals
- Provide resource support for services including employment, housing, participant direction, independent living, justice, and foster care
- Facilitate timely access to needed care and services
- Conduct telephonic, digital, home, and/or other site outreach
- Collect, document, and maintain member information and care management activities for regulatory compliance
- Educate members and families/caregivers about disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits
- Provide leadership feedback on opportunities to improve care quality and cost-effectiveness
- Perform other assigned duties and comply with policies and standards
Requirements:
- Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing
- 2–4 years of related experience
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required
- Strong physical and behavioral health experience
- Ability to assess member needs, barriers to care, and social determinants of health
- Ability to develop and maintain care plans/service plans
- Ability to coordinate with members, caregivers, providers, specialists, and community resources
- Ability to document and maintain member information and care management activities for regulatory compliance
Benefits:
- Competitive pay
- Health insurance
- 401K
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation
- Equal opportunity employer committed to diversity
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