Pediatric RN Care Manager -- Remote Available

Fidelis Care

Orlando Florida

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
  • Develop, assess and adjust, as necessary, the care plan and promote desired outcome
  • 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
  • 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
  • Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
  • 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
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • Additional Details:
    *Department: Children's Medical Services
    *Caseload: Pediatrics - Newborn to 21-year olds. Based on residence location.
    *Territory: Orange County (Orlando, FL area). Work-from-home case management role with indefinitely suspended home visits due to COVID-19. Field/Local travel. Travel will be 70%. Must reside in or be willing to relocate to the above mentioned area of Florida.

    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
  • Education/Experience:

    Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred.

    Licenses/Certifications: Current state’s RN license.

    For Sunshine Health (FL) Only: Employees supporting Florida's Children’s Medical Services (CMS) must have a minimum of two years of pediatric experience.


    Pediatric RN Care Manager -- Remote Available

    Fidelis Care

    Orlando Florida

    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
  • Develop, assess and adjust, as necessary, the care plan and promote desired outcome
  • 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
  • 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
  • Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
  • 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
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • Additional Details:
    *Department: Children's Medical Services
    *Caseload: Pediatrics - Newborn to 21-year olds. Based on residence location.
    *Territory: Orange County (Orlando, FL area). Work-from-home case management role with indefinitely suspended home visits due to COVID-19. Field/Local travel. Travel will be 70%. Must reside in or be willing to relocate to the above mentioned area of Florida.

    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
  • Education/Experience:

    Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred.

    Licenses/Certifications: Current state’s RN license.

    For Sunshine Health (FL) Only: Employees supporting Florida's Children’s Medical Services (CMS) must have a minimum of two years of pediatric experience.