Care Manager (RN)

Centene Corporation•Remote-NJ, NJ

9d•$56,200 - $101,000•Remote

About The Position

Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high-quality, cost-effective healthcare outcomes, including personalized care plans and education for members and their families. This is a remote, field-based position requiring up to 75% local travel to conduct in-home member visits throughout the assigned service area. Candidates must hold an active New Jersey Registered Nurse (RN) license and should reside in Hudson, Essex, or Union County. The typical schedule is Monday through Friday, 8:00 AM to 5:00 PM ET, with flexibility based on member and business needs. Bilingual Spanish-speaking candidates are strongly preferred. The Care Manager evaluates member needs and barriers to appropriate care, including social determinants of health, and develops or facilitates care plans based on the member’s priorities. The role coordinates with members, families, caregivers, providers, specialists, and community resources; monitors progress and changes in member status; documents care management activities; and provides education and resource support. The position also provides leadership feedback on opportunities to improve care quality and cost-effective delivery. Centene describes its work as supporting people, families, and communities through more accessible and effective healthcare. The company offers a comprehensive benefits package, and pay may vary based on skills, experience, education, and other job-related factors permitted by law.

Requirements

Degree from an accredited school of nursing or a bachelor's degree in nursing.
2–4 years of related experience.
Active RN state licensure and/or compact state licensure; the position details specify an active New Jersey RN license.
Candidates should reside in Hudson, Essex, or Union County, New Jersey.
Ability to conduct in-home member visits throughout the assigned service area, involving up to 75% local travel.

Nice To Haves

Bilingual Spanish-speaking ability is strongly preferred.

Responsibilities

Evaluate member needs, barriers to accessing appropriate care, and social determinants of health, prioritizing concerns identified by the member and recommending or facilitating plans for the best outcome.
Develop ongoing care plans or service plans and collaborate with providers to identify providers, specialists, and community resources that address unmet needs.
Identify problems or barriers to care and provide appropriate care management interventions.
Coordinate between members and/or their families or caregivers and the care provider team to ensure 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 such as employment, housing, participant direction, independent living, justice, and foster care, as appropriate.
Facilitate care management and collaborate with providers or specialists to help members access needed care or services in a timely manner.
Conduct telephonic, digital, in-home, or other site outreach to assess member needs and collaborate with resources.
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 their families or caregivers on disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits.
Provide leadership with feedback about opportunities to improve and enhance care and quality delivery cost-effectively.
Perform other duties or responsibilities as assigned to meet business needs and comply with applicable policies and standards.