Care Manager II (RN) --Remote Available
Envolve Pharmacy Solutions
2021-09-28T04:13:43Z
San Antonio
Texas
United States
Healthcare - Nursing
(No Timezone Provided)
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
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 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 Our 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 Texas Requirements:
Education/Experience:
Graduate from an Accredited School of Nursing. Bachelor’s 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 state’s RN license.
Care Manager II (RN) --Remote Available
Envolve Pharmacy Solutions
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
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 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 Our 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 Texas Requirements:
Education/Experience:
Graduate from an Accredited School of Nursing. Bachelor’s 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 state’s RN license.