Perform collaborative duties to assess, plan and coordinate continuum of care for select members at high risk in order to promote quality, cost effective programs.
Bachelor’s degree preferred. At least two years clinical nursing experience. At least two years experience managed care environment. Must be independent, self-starter.
•Participate in face to face visits with high risk members at point of service in the community and in the member's home to address healthcare needs and promote positive healthcare outcomes.
•Collaborate with members to identify medical needs and collaborate with medical and community resources to enhance desired healthcare outcomes.
•Provide education and resources to members to assist them with managing their disease processes and other healthcare needs.
•Develop, assess and adjust as necessary the care plan and promote desired outcome.
•Coordinate services among Primary Care Physician (PCP), specialist, and other medical and non-medical providers as necessary to meet the complete medical socio economic needs of clients.
•Provide patient and provider education.
•Identify related risk management quality concerns and report these scenarios to the appropriate resources.
•Data enters assessments and authorizations into the system.
RN required. Current state nursing and driver’s license. CCM (Certified Case Manager) or other clinical certification preferred.
Company car program available for case management positions meeting the required travel criteria.
Centene is sensitive to the needs of individuals and families enrolled in government-assisted health programs. The company provides managed...