Care Manager (RN) - OB

Centene Corporation•Remote-MO, MO

21d•$56,200 - $101,000•Remote

About The Position

Develops, assesses, and facilitates complex care management activities for primarily physical needs members to support high-quality, cost-effective healthcare outcomes. The role includes creating personalized care plans and providing education to members and their families. This Care Manager provides education and support to pregnant members and may work remotely from home anywhere within Missouri. The schedule is Monday through Friday, 8 a.m. to 5 p.m. The role evaluates member needs, barriers to care, and social determinants of health, with a focus on priorities identified by the member. It develops and monitors care plans, coordinates with providers and community resources, facilitates access to appropriate services, and educates members and caregivers. The Care Manager documents activities to meet applicable regulatory requirements and provides feedback to leadership about opportunities to improve cost-effective care and quality delivery. Other duties may be assigned as needed.

Requirements

Degree from an accredited school of nursing or a bachelor's degree in nursing.
2–4 years of related experience.
Registered Nurse (RN) state licensure and/or compact state licensure required.

Responsibilities

Evaluate member needs, barriers to accessing appropriate care, and social determinants of health, focusing on the member's priorities and recommending or facilitating plans to achieve the best outcomes.
Develop ongoing care or service plans and collaborate with providers to identify providers, specialists, and community resources to address unmet needs.
Identify problems and barriers to care and provide appropriate care management interventions.
Coordinate among members, families or caregivers, and care provider teams to ensure members receive adequate, appropriate, person-centered care or services.
Follow up and monitor member status, changes in condition, and progress toward care plan or service plan goals; collaborate with members, caregivers, and providers to revise plans as needed.
Provide resource support to members and care managers for local services, including employment, housing, participant direction, independent living, justice, and foster care resources, as appropriate to assessments and plans.
Facilitate care management and collaborate with providers or specialists to ensure timely access to needed care or services.
Conduct telephonic, digital, home, or other site outreach to assess member needs and collaborate with resources, as needed.
Collect, document, and maintain member information and care management activities to ensure compliance with applicable state, federal, and third-party payer regulations.
Provide or facilitate education for members and families or caregivers on disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits.
Provide leadership with feedback on opportunities to improve care and quality delivery for members in a cost-effective manner.
Perform other duties as assigned and comply with all policies and standards.